NPIMap

Organization Active NPI

Lifelinc Anesthesia II, PLLC

  • Anesthesiology Physician
  • Springfield, TN
National Provider Identifier
1821397233
Registry record updated Nov 4, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
Legal business name
LIFELINC ANESTHESIA II, PLLC
Practice address
100 Northcrest Dr
Springfield, TN 37172
Phone
(901) 844-1590
Fax
(901) 844-1592
NPI assigned
Mar 24, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 4, 2023

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

Authorized official

Name
Erica N Warren, MHA
Title
Administrator/Coo
Phone
(901) 844-1590

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

100 Northcrest Dr
Springfield, TN 37172

Mailing address

3340 Players Club Pkwy Ste 350
Memphis, TN 38125-8949
Phone (901) 844-1590

Other practice location 1

631 Rb Wilson Dr
Huntingdon, TN 38344-1727
Phone (731) 986-4461

Other practice location 2

786 Estate Pl
Memphis, TN 38120-0600
Phone (901) 287-4100

Other practice location 3

5999 Park Ave
Memphis, TN 38119-5200
Phone (901) 818-1080

Other practice location 4

9 Physicians Dr
Jackson, TN 38305-2071
Phone (731) 661-0086

Other practice location 5

301 Tyson Ave
Paris, TN 38242-4544
Phone (731) 644-8535

Other practice location 6

467 N Whitney Ave
Cookeville, TN 38501-2454
Phone (931) 528-5007

Other practice location 7

1 Medical Center Blvd
Cookeville, TN 38501-4294
Phone (931) 528-2541

Other practice location 8

907 E LaMar Alexander Pkwy
Maryville, TN 37804-5015
Phone (865) 983-7211

Other identifiers 3

IdentifierTypeStateIssuer
7100162450MedicaidKY
7100169260MedicaidKY
1523636MedicaidTN

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110512000311 TN Part B Supplier - Clinic/Group Practice 2668658493 Receives reassigned benefits from 204 practitioners
Practice locations: Memphis, TN; Springfield, TN; Huntingdon, TN; Cookeville, TN; Bartlett, TN

National Provider Directory

National Provider Directory

Locations

786 Estate Pl
Memphis, TN 38120
Phone (901) 287-4100

Practitioners & affiliated clinicians

Practitioners 204

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 204

NPI Registry JSON

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

{
    "created_epoch": "1300924800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1699056000000",
    "number": "1821397233",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3340 PLAYERS CLUB PKWY STE 350",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381258949",
            "telephone_number": "901-844-1590",
            "fax_number": "901-844-1592"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 NORTHCREST DR",
            "city": "SPRINGFIELD",
            "state": "TN",
            "postal_code": "37172",
            "telephone_number": "901-844-1590",
            "fax_number": "901-844-1592"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "631 Rb Wilson Dr",
            "address_purpose": "LOCATION",
            "city": "Huntingdon",
            "state": "TN",
            "postal_code": "383441727",
            "country_code": "US",
            "telephone_number": "731-986-4461",
            "fax_number": "901-844-1592",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "786 Estate Pl",
            "address_purpose": "LOCATION",
            "city": "Memphis",
            "state": "TN",
            "postal_code": "381200600",
            "country_code": "US",
            "telephone_number": "901-287-4100",
            "fax_number": "901-844-1592",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5999 Park Ave",
            "address_purpose": "LOCATION",
            "city": "Memphis",
            "state": "TN",
            "postal_code": "381195200",
            "country_code": "US",
            "telephone_number": "901-818-1080",
            "fax_number": "901-844-1592",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "9 Physicians Dr",
            "address_purpose": "LOCATION",
            "city": "Jackson",
            "state": "TN",
            "postal_code": "383052071",
            "country_code": "US",
            "telephone_number": "731-661-0086",
            "fax_number": "901-844-1592",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "301 Tyson Ave",
            "address_purpose": "LOCATION",
            "city": "Paris",
            "state": "TN",
            "postal_code": "382424544",
            "country_code": "US",
            "telephone_number": "731-644-8535",
            "fax_number": "731-642-9588",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "467 N Whitney Ave",
            "address_purpose": "LOCATION",
            "city": "Cookeville",
            "state": "TN",
            "postal_code": "385012454",
            "country_code": "US",
            "telephone_number": "931-528-5007",
            "fax_number": "901-844-1592",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1 Medical Center Blvd",
            "address_purpose": "LOCATION",
            "city": "Cookeville",
            "state": "TN",
            "postal_code": "385014294",
            "country_code": "US",
            "telephone_number": "931-528-2541",
            "fax_number": "901-844-1592",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "907 E LaMar Alexander Pkwy",
            "address_purpose": "LOCATION",
            "city": "Maryville",
            "state": "TN",
            "postal_code": "378045015",
            "country_code": "US",
            "telephone_number": "865-983-7211",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "LIFELINC ANESTHESIA II, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-03-24",
        "last_updated": "2023-11-04",
        "certification_date": "2023-11-04",
        "status": "A",
        "authorized_official_last_name": "WARREN",
        "authorized_official_first_name": "ERICA",
        "authorized_official_middle_name": "N",
        "authorized_official_title_or_position": "ADMINISTRATOR/COO",
        "authorized_official_telephone_number": "901-844-1590",
        "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": "7100162450",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100169260",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1523636",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Springfield, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2023; 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.