Individual provider Active NPI

Richmond A Higginbotham, CRNA

  • Certified Registered Nurse Anesthetist
  • Jackson, TN
National Provider Identifier
1831185503
Registry record updated Mar 29, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
APN10724 Issued in TN
Practice address
620 Skyline Dr
Jackson, TN 38301-3923
Phone
(731) 541-7070
Fax
(731) 541-7075
NPI assigned
Sep 27, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 29, 2018

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 APN10724 TN Primary

Addresses

Primary practice location

620 Skyline Dr
Jackson, TN 38301-3923

Mailing address

620 Skyline Dr
Jackson, TN 38301-3923
Phone (731) 541-7070

Other identifiers 1

IdentifierTypeStateIssuer
3627662MedicaidTN

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041221000332 TN Practitioner - Certified Registered Nurse Anesthetist (Crna) 4284527680 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Medical Center Anesthesia, IncGroup PAC ID 2769629187, 107 clinicians

Practice addresses (Care Compare)

620 Skyline Dr
Jackson, TN 38301-3923
Phone (731) 541-5000

Hospital & facility affiliations

  • Jackson-Madison County General Hospital Hospital, Jackson, TN, CCN 440002

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
APN10724TNMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Medical Center Anesthesia Inc. Nurse Anesthetist, Certified Registered CurrentSince Apr 1, 2013 Accepting new patients
American Anesthesiology of Tennessee, P.C. CurrentSince Jan 1, 2016 Accepting new patients
American Anesthesiology of Tennessee, P.C. Nurse Anesthetist, Certified Registered CurrentSince Jan 1, 2016 Accepting new patients
Professional Anesthesia Associates Past Accepting new patients
Jackson Anesthesiology Group, PLLC PastSince Dec 6, 2020 Accepting new patients

Locations

620 Skyline Dr
Jackson, TN 38301
Phone (731) 541-4923

9300 Park West Blvd
Knoxville, TN 37923
Phone (865) 427-4040

501 20th St
Ste 606
Knoxville, TN 37916
Phone (865) 331-2278

Organizations & group practices 5

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1127779200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1522281600000",
    "number": "1831185503",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "620 SKYLINE DR",
            "city": "JACKSON",
            "state": "TN",
            "postal_code": "383013923",
            "telephone_number": "731-541-7070",
            "fax_number": "731-541-7075"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "620 SKYLINE DR",
            "city": "JACKSON",
            "state": "TN",
            "postal_code": "383013923",
            "telephone_number": "731-541-7070",
            "fax_number": "731-541-7075"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HIGGINBOTHAM",
        "first_name": "RICHMOND",
        "middle_name": "A",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-27",
        "last_updated": "2018-03-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "TN",
            "license": "APN10724",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3627662",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jackson, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 2018; 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.