Individual provider Active NPI

James P Root, CRNA

  • Certified Registered Nurse Anesthetist
  • Kingsport, TN
National Provider Identifier
1720071756
Registry record updated Dec 17, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
RN0000112726 Issued in TN
Practice address
713 Yadkin St
Kingsport, TN 37660-4933
Phone
(423) 245-4935
NPI assigned
Aug 24, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 17, 2008

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X RN0000112726 TN Primary

Addresses

Primary practice location

713 Yadkin St
Kingsport, TN 37660-4933

Mailing address

713 Yadkin St
Kingsport, TN 37660-4933
Phone (423) 245-4935

Other identifiers 1

IdentifierTypeStateIssuer
3625738MedicaidTN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20031120000952 TN Practitioner - Certified Registered Nurse Anesthetist (Crna) 7315841442 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Smokey Mountain Anesthesia PCGroup PAC ID 0749194363, 9 clinicians

Practice addresses (Care Compare)

110 Med Tech Pkwy
Johnson City, TN 37604-4004
Phone (423) 639-0941

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
RN0000112726TNMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Smokey Mountain Anesthesia PC Nurse Anesthetist, Certified Registered CurrentSince Jan 1, 2004 Accepting new patients
Norton Community Physician Services LLC Past Accepting new patients
Norton Community Physician Services LLC Past Accepting new patients
Premier Anesthesia Services PC Past Accepting new patients
Terrebonne Parish Hospital Service District #1 Past Accepting new patients
Anesthesia and Pain Consultants,P.C. Nurse Anesthetist, Certified Registered PastSince Mar 1, 2000 Accepting new patients

Locations

110 Med Tech Pkwy
Johnson City, TN 37604
Phone (423) 722-0340

110 Med Tech Pkwy
Ste 2
Johnson City, TN 37604
Phone (423) 722-0371

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1124841600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1229472000000",
    "number": "1720071756",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "713 YADKIN ST",
            "city": "KINGSPORT",
            "state": "TN",
            "postal_code": "376604933",
            "telephone_number": "423-245-4935"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "713 YADKIN ST",
            "city": "KINGSPORT",
            "state": "TN",
            "postal_code": "376604933",
            "telephone_number": "423-245-4935"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROOT",
        "first_name": "JAMES",
        "middle_name": "P",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-24",
        "last_updated": "2008-12-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "TN",
            "license": "RN0000112726",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3625738",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kingsport, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.