Individual provider Active NPI

Susan Diann Patterson, CRNA

  • Certified Registered Nurse Anesthetist
  • Morristown, TN
National Provider Identifier
1780679928
Registry record updated Mar 15, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
RN0000042466 Issued in TN
Practice address
1027 E Main St
Morristown, TN 37814-6632
Phone
(423) 581-5984
Fax
(423) 581-0984
NPI assigned
Sep 14, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 15, 2010

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 RN0000042466 TN Primary

Addresses

Primary practice location

1027 E Main St
Morristown, TN 37814-6632

Mailing address

PO Box 1718
Morristown, TN 37816-1718
Phone (423) 581-5987

Other identifiers 2

IdentifierTypeStateIssuer
3605561MedicaidTN
3091980OtherTNBCBS

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080613000025 TN Practitioner - Certified Registered Nurse Anesthetist (Crna) 7810068186 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 1980
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1124 E Weisgarber Rd
Suite 110
Knoxville, TN 37909-2600
Phone (865) 588-1037

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
8912TNMDPhysical Therapist
RN0000042466TNMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Knoxville Ophthalmology ASC, LLC Nurse Anesthetist, Certified Registered CurrentSince Dec 2, 2019 Accepting new patients
Knoxville Ophthalmology ASC, LLC Past Accepting new patients

Locations

1124 E Weisgarber Rd
Ste 110
Knoxville, TN 37909
Phone (865) 588-1037

Organizations & group practices 2

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": "1126656000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1268611200000",
    "number": "1780679928",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1718",
            "city": "MORRISTOWN",
            "state": "TN",
            "postal_code": "378161718",
            "telephone_number": "423-581-5987",
            "fax_number": "423-581-0984"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1027 E MAIN ST",
            "city": "MORRISTOWN",
            "state": "TN",
            "postal_code": "378146632",
            "telephone_number": "423-581-5984",
            "fax_number": "423-581-0984"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATTERSON",
        "first_name": "SUSAN",
        "middle_name": "DIANN",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-09-14",
        "last_updated": "2010-03-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "TN",
            "license": "RN0000042466",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3605561",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "3091980",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Morristown, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 2010; 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.