Individual provider Active NPI

Benny C Davis, CRNA

  • Certified Registered Nurse Anesthetist
  • Sevierville, TN
National Provider Identifier
1821088733
Registry record updated Dec 6, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
RN52524 Issued in TN
Practice address
709 Middle Creek Rd
Sevierville, TN 37862-5047
Phone
(952) 442-9770
NPI assigned
Oct 24, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 6, 2013

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 RN52524 TN Primary

Addresses

Primary practice location

709 Middle Creek Rd
Sevierville, TN 37862-5047

Mailing address

233 W 1St St
Waconia, MN 55387-1302
Phone (952) 442-9770

Other identifiers 2

IdentifierTypeStateIssuer
3028585OtherTNBLUE CROSS BLUE SHIELD
3601996MedicaidTN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC, TN, SC3 enrollments

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
I20051205000568 NC Practitioner - Certified Registered Nurse Anesthetist (Crna) 6507754421
I20070927001017 TN Practitioner - Certified Registered Nurse Anesthetist (Crna) 6507754421 Reassigns benefits to 2 organizations
I20161115000044 SC Practitioner - Certified Registered Nurse Anesthetist (Crna) 6507754421 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
9113TNMDPharmacist
RN52524TNMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Northeast Tennessee Anesthesia, PLLC Nurse Anesthetist, Certified Registered CurrentSince Jan 1, 2019 Accepting new patients
Pathology Associates of Greenville PA Current Accepting new patients
Resource Anesthesia, P.C. Nurse Anesthetist, Certified Registered CurrentSince Mar 25, 2017 Accepting new patients
Greenville Health System Current Accepting new patients
Prisma Health-Upstate CurrentSince Oct 1, 2016 Accepting new patients
Unity Urology PC CurrentSince Jun 17, 2022 Accepting new patients
Prisma Health-Upstate CurrentSince Oct 1, 2016 Accepting new patients
Greenville Health System CurrentSince Oct 14, 2016 Accepting new patients
Prisma Health-Upstate Current Accepting new patients
Nurse Anesthesia of North Carolina, PLLC Nurse Anesthetist, Certified Registered Past Accepting new patients
Sevier Anesthesia Associates, P.C Nurse Anesthetist, Certified Registered Past Accepting new patients
Upper Cumberland Anesthesia Associates, PC Nurse Anesthetist, Certified Registered PastSince Apr 19, 2020 Accepting new patients

Locations

22725 US Highway 76
Clinton, SC 29325
Phone (864) 833-9100

175 Patewood Dr
Greenville, SC 29615
Phone (864) 797-1000

1 Independence Pt
Ste 212
Greenville, SC 29615
Phone (864) 797-6306

701 Grove Rd
Greenville, SC 29605
Phone (864) 454-2030

100 Augusta St
Greenville, SC 29601
Phone (864) 455-2600

830 S Buncombe Rd
Greer, SC 29650
Phone (864) 797-8000

298 Memorial Dr
Seneca, SC 29672
Phone (864) 482-3100

729 SE Main St
Simpsonville, SC 29681
Phone (864) 271-8647

807 N Main St
Travelers Rst, SC 29690
Phone (864) 834-5132

189 Liberty Way
Greeneville, TN 37745
Phone (423) 638-4046

10461 Wallace Alley St
Kingsport, TN 37663
Phone (423) 279-1400

12752 Kingston Pike
Ste E202
Knoxville, TN 37934
Phone (877) 277-9030

550 Fort Loudoun Med Center Dr
Lenoir City, TN 37772
Phone (865) 271-6000

550 Fort Loudon Medical Center Dr
#C
Lenoir City, TN 37772

Organizations & group practices 12

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": "1130112000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1386288000000",
    "number": "1821088733",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "233 W 1ST ST",
            "city": "WACONIA",
            "state": "MN",
            "postal_code": "553871302",
            "telephone_number": "952-442-9770",
            "fax_number": "952-442-3620"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "709 MIDDLE CREEK RD",
            "city": "SEVIERVILLE",
            "state": "TN",
            "postal_code": "378625047",
            "telephone_number": "952-442-9770"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "BENNY",
        "middle_name": "C",
        "credential": "CRNA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-10-24",
        "last_updated": "2013-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "TN",
            "license": "RN52524",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "3028585",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3601996",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sevierville, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 2013; 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.