Individual provider Active NPI

Nathaniel K Nutt

  • Certified Registered Nurse Anesthetist
  • Miami, FL
National Provider Identifier
1750558243
Registry record updated Mar 18, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
AC003011 Issued in MD
Practice address
1400 NW 12TH Ave
Miami, FL 33136-1003
Phone
(305) 689-5376
Fax
(305) 689-3990
NPI assigned
May 13, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 18, 2026

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X AC003011 MD Primary
Certified Registered Nurse Anesthetist 367500000X 0024182415 VA
Certified Registered Nurse Anesthetist 367500000X RN527148L PA
Certified Registered Nurse Anesthetist 367500000X ARNP92782992 FL

Addresses

Primary practice location

1400 NW 12TH Ave
Miami, FL 33136-1003

Mailing address

1400 NW 12TH Ave
Miami, FL 33136-1003
Phone (305) 689-5376

Other practice location 1

1201 Sam Perry Blvd Ste 101
Fredericksburg, VA 22401-4490
Phone (540) 741-7614

Other practice location 2

1001 Sam Perry Blvd
Fredericksburg, VA 22401-4453
Phone (540) 741-7614

Other practice location 3

101 Hospital Center Blvd
Stafford, VA 22554-6200
Phone (540) 741-7614

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20211005003682 VA Practitioner - Certified Registered Nurse Anesthetist (Crna) 2860555810 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mary Washington Healthcare Specialty Services, LLCGroup PAC ID 5991605826, 136 clinicians
SMG Anesthesia Specialists LLCGroup PAC ID 6305081118, 501 clinicians

Practice addresses (Care Compare)

1001 Sam Perry Blvd
Fredericksburg, VA 22401-4453
Phone (540) 741-7614

2025 Glenn Mitchell Dr
Virginia Beach, VA 23456-0178
Phone (757) 507-1000

Hospital & facility affiliations

  • Sentara Northern Virginia Medical Center Hospital, Woodbridge, VA, CCN 490113
  • Mary Washington Hospital Hospital, Fredericksburg, VA, CCN 490022

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
ARNP92782992FLMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Surgical Anesthesia Associates, PLLC CurrentSince Jan 1, 2023 Accepting new patients
SMG Anesthesia Specialists LLC CurrentSince Sep 30, 2024 Accepting new patients
Premier Anesthesia of Virginia LLC Nurse Anesthetist, Certified Registered CurrentSince Sep 13, 2021 Accepting new patients
Premier Anesthesia of Pennsylvania PC Nurse Anesthetist, Certified Registered Past Accepting new patients

Locations

2655 Northwinds Pkwy
Alpharetta, GA 30009
Phone (678) 690-7804

4600 Spotsylvania Pkwy
Fredericksburg, VA 22408
Phone (540) 498-4000

2025 Glenn Mitchell Dr
Virginia Beach, VA 23456
Phone (757) 507-1000

100 Sentara Cir
Williamsburg, VA 23188
Phone (678) 690-7826

2300 Opitz Blvd
Woodbridge, VA 22191
Phone (703) 523-1000

Interoperability endpoints

  • Direct secure messaging: nnutt46026@direct.med.miami.edu

Organizations & group practices 5

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.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1210636800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1773792000000",
    "number": "1750558243",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1400 NW 12TH AVE",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331361003",
            "telephone_number": "305-689-5376",
            "fax_number": "305-689-3990"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 NW 12TH AVE",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331361003",
            "telephone_number": "305-689-5376",
            "fax_number": "305-689-3990"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1201 Sam Perry Blvd Ste 101",
            "address_purpose": "LOCATION",
            "city": "Fredericksburg",
            "state": "VA",
            "postal_code": "224014490",
            "country_code": "US",
            "telephone_number": "540-741-7614",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1001 Sam Perry Blvd",
            "address_purpose": "LOCATION",
            "city": "Fredericksburg",
            "state": "VA",
            "postal_code": "224014453",
            "country_code": "US",
            "telephone_number": "540-741-7614",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "101 Hospital Center Blvd",
            "address_purpose": "LOCATION",
            "city": "Stafford",
            "state": "VA",
            "postal_code": "225546200",
            "country_code": "US",
            "telephone_number": "540-741-7614",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NUTT",
        "first_name": "NATHANIEL",
        "middle_name": "K",
        "name_prefix": "Mr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-05-13",
        "last_updated": "2026-03-18",
        "certification_date": "2026-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MD",
            "license": "AC003011",
            "primary": true
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "VA",
            "license": "0024182415",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "PA",
            "license": "RN527148L",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "FL",
            "license": "ARNP92782992",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Miami, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2026; 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.