NPIMap

Organization Active NPI

Lifelinc Anesthesia, PLLC

  • Anesthesiology Physician
  • Memphis, TN
National Provider Identifier
1801021464
Registry record updated Sep 29, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
Legal business name
LIFELINC ANESTHESIA, PLLC
Practice address
3340 Players Club Pkwy Ste 350
Memphis, TN 38125-8949
Phone
(901) 207-2017
Fax
(844) 752-2163
NPI assigned
May 26, 2009
Last updated
Sep 29, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 29, 2020

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

Authorized official

Name
Erica N Warren, MHA
Title
Coo
Phone
(901) 207-2017

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207L00000X Primary
Certified Registered Nurse AnesthetistGroup: 193200000X MULTI-SPECIALTY GROUP 367500000X

Addresses

Primary practice location

3340 Players Club Pkwy Ste 350
Memphis, TN 38125-8949

Mailing address

3340 Players Club Pkwy
Suite 350
Memphis, TN 38125-8933
Phone (901) 207-2017

Other identifiers 12

IdentifierTypeStateIssuer
1029018500001MedicaidPA
7100313110MedicaidKY
002565700MedicaidFL
01886811MedicaidMS
GPB038MedicaidSC
003116254AMedicaidGA
005473200MedicaidFL
005473201MedicaidFL
179927002MedicaidAR
1514226MedicaidTN
005473202MedicaidFL
005473203MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN, GA, FL, MD, MS, PA, KY, VA, SC, AL10 enrollments

Enrollment records 10

Enrollment IDStateProvider typePAC IDDetails
O20091231000232 TN Part B Supplier - Clinic/Group Practice 0941347447 Receives reassigned benefits from 104 practitioners
Practice locations: Covington, TN; Memphis, TN; Savannah, TN
O20111011000074 GA Part B Supplier - Clinic/Group Practice 0941347447 Receives reassigned benefits from 16 practitioners
Practice locations: Augusta, GA; Atlanta, GA
O20111020000241 FL Part B Supplier - Clinic/Group Practice 0941347447 Receives reassigned benefits from 4 practitioners
Practice locations: Englewood, FL
O20121211000165 MD Part B Supplier - Clinic/Group Practice 0941347447 Receives reassigned benefits from 5 practitioners
Practice locations: Salisbury, MD
O20130522000277 MS Part B Supplier - Clinic/Group Practice 0941347447 Receives reassigned benefits from 285 practitioners
Practice locations: Yazoo City, MS; Southaven, MS; Philadelphia, MS; Oxford, MS; Olive Branch, MS; New Albany, MS; Laurel, MS; Kosciusko, MS…
O20140206000167 PA Part B Supplier - Clinic/Group Practice 0941347447 Receives reassigned benefits from 7 practitioners
Practice locations: Indiana, PA
O20140522001233 KY Part B Supplier - Clinic/Group Practice 0941347447 Receives reassigned benefits from 20 practitioners
Practice locations: Hopkinsville, KY; Princeton, KY; Crestview Hills, KY
O20180130000628 VA Part B Supplier - Clinic/Group Practice 0941347447 Receives reassigned benefits from 10 practitioners
Practice locations: Hampton, VA
O20250203000586 SC Part B Supplier - Clinic/Group Practice 0941347447 Receives reassigned benefits from 20 practitioners
Practice locations: Clinton, SC; Greenville, SC
O20250529000837 AL Part B Supplier - Clinic/Group Practice 0941347447 Receives reassigned benefits from 29 practitioners
Practice locations: Saraland, AL

National Provider Directory

National Provider Directory

Locations

501 Marshall St
Ste 2
Jackson, MS 39202

499 Azalea Dr
Oxford, MS 38655
Phone (662) 234-7979

7600 Airways Blvd
Ste D
Southaven, MS 38671
Phone (662) 349-7477

7900 Airways Blvd
Bldg A3
Southaven, MS 38671
Phone (662) 349-6113

1265 Wayne Ave
Indiana, PA 15701
Phone (724) 349-3110

9 Physicians Dr
Jackson, TN 38305
Phone (731) 661-0086

3340 Players Club Pkwy
Ste 350
Memphis, TN 38125
Phone (901) 207-2017

Practitioners & affiliated clinicians

Practitioners 477

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 477

NPI Registry JSON

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

{
    "created_epoch": "1243296000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1601337600000",
    "number": "1801021464",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3340 PLAYERS CLUB PKWY",
            "address_2": "SUITE 350",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381258933",
            "telephone_number": "901-207-2017",
            "fax_number": "844-752-2163"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3340 PLAYERS CLUB PKWY STE 350",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381258949",
            "telephone_number": "901-207-2017",
            "fax_number": "844-752-2163"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFELINC ANESTHESIA, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-05-26",
        "last_updated": "2020-09-29",
        "certification_date": "2020-09-29",
        "status": "A",
        "authorized_official_last_name": "WARREN",
        "authorized_official_first_name": "ERICA",
        "authorized_official_middle_name": "N",
        "authorized_official_title_or_position": "COO",
        "authorized_official_telephone_number": "901-207-2017",
        "authorized_official_credential": "MHA"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Anesthesiology",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "367500000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1029018500001",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100313110",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "002565700",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01886811",
            "state": "MS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GPB038",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003116254A",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "005473200",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "005473201",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "179927002",
            "state": "AR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1514226",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "005473202",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "005473203",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Memphis, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.