Mid-State Endoscopy Center LLC

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

210 Issued in TN

Legal business name

MID-STATE ENDOSCOPY CENTER LLC

Doing business as

Anesthesia Services of MState

Practice address

1115 Dow St
Ste a
Murfreesboro, TN 37130-2487

Phone

(615) 848-9234

Fax

(615) 893-3188

NPI assigned

Feb 15, 2011

Reactivated

Nov 30, 2015

Last updated

Feb 1, 2021By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Christopher Hartshorn

Title

Officer/Authorized Official

Phone

(314) 800-2017

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Anesthesia Services of MState Doing business as

Member of 3

Organizations this organization is a member of, according to the National Provider Directory.

• Saint Thomas Health

  dba Ascension Rx 1205

  • Community/Retail Pharmacy
  • McMinnville, TN
  • NPI 1528634458

  Member Of

  NPD member
• Baylor University Medical Center

  • Durable Medical Equipment & Medical Supplies
  • Dallas, TX
  • NPI 1518967231

  Member Of

  NPD member
• VHS San Antonio Partners LLC

  dba Baptist Health System

  • Psychiatric Hospital Unit
  • San Antonio, TX
  • NPI 1487633509

  Member Of

  NPD member

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

{
    "created_epoch": "1297728000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1612137600000",
    "number": "1811294531",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14201 DALLAS PKWY",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752542916",
            "telephone_number": "615-848-9234",
            "fax_number": "615-893-3188"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1115 DOW ST",
            "address_2": "STE A",
            "city": "MURFREESBORO",
            "state": "TN",
            "postal_code": "371302487",
            "telephone_number": "615-848-9234",
            "fax_number": "615-893-3188"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MID-STATE ENDOSCOPY CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-02-15",
        "last_updated": "2021-02-01",
        "certification_date": "2021-02-01",
        "deactivation_date": "2015-10-12",
        "reactivation_date": "2015-11-30",
        "status": "A",
        "authorized_official_last_name": "HARTSHORN",
        "authorized_official_first_name": "CHRISTOPHER",
        "authorized_official_title_or_position": "OFFICER/AUTHORIZED OFFICIAL",
        "authorized_official_telephone_number": "314-800-2017"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "TN",
            "license": "210",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P01044051",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Anesthesia Services of MState",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Anesthesia Services of MState",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Sonja Mariana Michello, COTA
• Mid South Psychiatric Associates
• Mid State Endo Uap, LLC
• Mid- TN Therapeutic Clinic
• Mid-State Endoscopy Center LLC
• Mid-State Gastroenterology, PLLC
• Mid-State Neurosurgery PC
• Mid-State Surgery PLLC
• Middle Tennessee Ambulatory Surgery Center, L.P.
• Middle Tennessee Blvd Healthcare LLC (Boulevard Pines Health & Rehab Center)

• Certified Registered Nurse Anesthetist in Murfreesboro, TN
• Providers in Murfreesboro, TN by specialty
• Certified Registered Nurse Anesthetist in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.