Individual provider Active NPI

Kenneth M Mathews III, CRNA

  • Certified Registered Nurse Anesthetist
  • Chattanooga, TN
National Provider Identifier
1831450246
Registry record updated Oct 26, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
APN16499 Issued in TN
Practice address
2341 McCallie Ave
Suite 402
Chattanooga, TN 37404-3239
Phone
(423) 698-3309
Fax
(423) 624-6355
NPI assigned
Jun 1, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 26, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X RN153797 TN
Certified Registered Nurse Anesthetist 367500000X APN16499 TN Primary

Addresses

Primary practice location

2341 McCallie Ave
Suite 402
Chattanooga, TN 37404-3239

Mailing address

PO Box 3549
Chattanooga, TN 37404-0549
Phone (423) 698-3309

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN, VA, NC3 enrollments

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
I20120627000607 TN Practitioner - Certified Registered Nurse Anesthetist (Crna) 4587829429 Reassigns benefits to 7 organizations
I20141209001004 VA Practitioner - Certified Registered Nurse Anesthetist (Crna) 4587829429 Reassigns benefits to 1 organization
I20210305001512 NC Practitioner - Certified Registered Nurse Anesthetist (Crna) 4587829429 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Medstream Anesthesia PLLCGroup PAC ID 7416198049, 571 clinicians

Practice addresses (Care Compare)

68 Hospital Rd
Sylva, NC 28779-2722
Phone (828) 586-7000

6801 Gov GC Peery Hwy
Richlands, VA 24641-2194
Phone (276) 596-6000

851 Locust St
Rogersville, TN 37857-2407
Phone (828) 398-5244

Hospital & facility affiliations

  • Twin County Regional Hospital Hospital, Galax, VA, CCN 490115

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
6521NCMDGeneral Practice Dentistry
16499TNMDOrthopedic Physical Therapist
APN16499TNMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Tennessee Anesthesiology LLC Nurse Anesthetist, Certified Registered CurrentSince Jun 20, 2016 Accepting new patients
Gastroenterology Associates Current Accepting new patients
Tennessee Valley Anesthesia Associates, LLC Nurse Anesthetist, Certified Registered CurrentSince Apr 1, 2021 Accepting new patients
Anesthesia Dynamics LLC Nurse Anesthetist, Certified Registered CurrentSince Aug 13, 2021 Accepting new patients
Gastroenterology Associates CurrentSince Sep 1, 2023 Accepting new patients
Northeast Tennessee Anesthesia, PLLC Nurse Anesthetist, Certified Registered CurrentSince Jun 1, 2023 Accepting new patients
American Anesthesiology of Tennessee, P.C. Current Accepting new patients
Anesthesiologists Associated PC Nurse Anesthetist, Certified Registered Past Accepting new patients
Anesthesiologists Associated PC Past Accepting new patients

Locations

2525 Desales Ave
Chattanooga, TN 37404
Phone (423) 495-2620

2515 Desales Ave
Chattanooga, TN 37404
Phone (423) 648-6672

310 N State of Franklin Rd
Ste 202
Johnson City, TN 37604
Phone (423) 434-3700

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

2204 Pavilion Dr
Ste 108
Kingsport, TN 37660
Phone (423) 392-6100

135 W Ravine Rd
Ste 3-A
Kingsport, TN 37660
Phone (423) 246-6777

2204 Pavilion Dr
Kingsport, TN 37660
Phone (423) 392-6100

2204 Pavilion Dr
Ste 105
Kingsport, TN 37660
Phone (423) 392-6100

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

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

851 Locust St
Rogersville, TN 37857
Phone (423) 272-2671

Organizations & group practices 10

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 2

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": "1338508800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698278400000",
    "number": "1831450246",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3549",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374040549",
            "telephone_number": "423-698-3309",
            "fax_number": "423-624-6355"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2341 MCCALLIE AVE",
            "address_2": "SUITE 402",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374043239",
            "telephone_number": "423-698-3309",
            "fax_number": "423-624-6355"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATHEWS",
        "first_name": "KENNETH",
        "middle_name": "M",
        "name_suffix": "III",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-06-01",
        "last_updated": "2023-10-26",
        "certification_date": "2023-10-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "TN",
            "license": "RN153797",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "TN",
            "license": "APN16499",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chattanooga, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2023; 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.