Penny M Green, CRNA
Individual provider Active NPI Certified Registered Nurse Anesthetist · Columbia, TN
NPI 1760425409 · NPPES record last updated Jul 9, 2007
Key facts
- NPI
- 1760425409
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Certified Registered Nurse Anesthetist 367500000X
- License
- 11236 (TN)
- Practice address
- 725 S James Campbell Blvd
Columbia, TN 38401-5962 - Phone
- (931) 728-5607
- Fax
- (931) 728-8354
- NPI assigned
- Jun 13, 2006
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 7
Medicare Care Compare profile
- Specialty
- Certified Registered Nurse Anesthetist (Crna)
- Education
- Other, 1998
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Anesthesia Associates of Columbia TN LLC
Practice addresses (Care Compare)
725 S James M Campbell Blvd
Columbia, TN 38401-5962
Phone (931) 381-7818
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in TN
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20040626000286 | TN | Practitioner - Certified Registered Nurse Anesthetist (Crna) | 6406832823 | Reassigns benefits to 3 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Certified Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 11236 | TN | MD | Certified Registered Nurse Anesthetist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Anesthesia Associates of Columbia TN LLC | Current |
Accepting new patients | |
| Pulaski Anesthesia Services LLC | Nurse Anesthetist, Certified Registered | Current |
Accepting new patients |
| Vanderbilt University Medical Center | Current |
Accepting new patients | |
| Anesthesia Care of Tullahoma, P.C. | Nurse Anesthetist, Certified Registered | Past | Accepting new patients |
| Anesthesia Medical Group, PC | Nurse Anesthetist, Certified Registered | Past | Accepting new patients |
| Highland Rim Anesthesia, P.C. | Past | Accepting new patients | |
| Cardiovascular Anesthesiologists PC | Nurse Anesthetist, Certified Registered | Past |
Accepting new patients |
Locations
Dept A T 40379
Atlanta, GA 31192
725 S James M Campbell Blvd
Columbia, TN 38401
Phone (931) 381-3700
1510 Hatcher Ln
Ste 18
Columbia, TN 38401
1510 Hatcher Ln
Columbia, TN 38401
Phone (931) 381-7818
719 Thompson Ln
Nashville, TN 37204
Phone (615) 322-6485
719 Thompson Ln
Ste 30330
Nashville, TN 37204
Phone (615) 936-3871
1265 E College St
Pulaski, TN 38478
Phone (931) 363-7531
1801 N Jackson St
Tullahoma, TN 37388
Phone (931) 393-3000
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Certified Registered Nurse Anesthetist | 367500000X | 11236 | TN | Yes |
Addresses
Primary practice location
725 S James Campbell Blvd
Columbia, TN 38401-5962
Mailing address
PO Box 299
Manchester, TN 37349-0299
Phone (931) 728-5607
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 3627696 | Medicaid | TN | |
| 3627699 | Medicaid | TN | |
| 4027418 | Other | TN | BLUECROSS |
Other providers in Columbia, TN
- Jennifer Gray
- Susan Thomas Gray
- Teresa Dianne Gray
- Jody Allison Green
- Kylie Green
- Katherine Clayton Greenwell
- Ruby Jean Greer
- Emily Gregg
- James Brian Gregory
- Rudy Lynn Gregory
All providers in Columbia, TN · Certified Registered Nurse Anesthetist in Tennessee
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 9, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.