Individual provider Active NPI

Lisa Kay Root, CRNA

  • Certified Registered Nurse Anesthetist
  • Johnson City, TN
National Provider Identifier
1841282134
Registry record updated Apr 24, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
RN0000114257 Issued in TN
Practice address
601 Med Tech Pkwy
Johnson City, TN 37604-2253
Phone
(423) 610-1020
NPI assigned
Aug 22, 2005
Last updated
Apr 24, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 24, 2019

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 RN0000114257 TN Primary

Addresses

Primary practice location

601 Med Tech Pkwy
Johnson City, TN 37604-2253

Mailing address

1009 Lark St Ste 2
Johnson City, TN 37604-8218
Phone (423) 283-0776

Other identifiers 1

IdentifierTypeStateIssuer
3625581MedicaidTN

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101209001337 TN Practitioner - Certified Registered Nurse Anesthetist (Crna) 8921295452 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Advanced Anesthesia Solutions IncGroup PAC ID 7315200664, 19 clinicians

Practice addresses (Care Compare)

320 Bristol W Blvd
Suite 1a
Bristol, TN 37620-8773
Phone (423) 639-0941

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RN0000114257TNMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Advanced Anesthesia Solutions Inc. Nurse Anesthetist, Certified Registered CurrentSince Jun 1, 2019 Accepting new patients
Meadowview ASC, LLC Past Accepting new patients

Locations

320 Bristol West Blvd
Ste 1A
Bristol, TN 37620
Phone (423) 758-1030

10425 Wallace Alley St
Kingsport, TN 37663
Phone (423) 282-9011

130 W Stone Dr
Kingsport, TN 37660

2033 Meadowview Ln
Ste 210
Kingsport, TN 37660
Phone (423) 343-7820

Dept 888618
Knoxville, TN 37995

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1124668800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1556064000000",
    "number": "1841282134",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1009 LARK ST STE 2",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376048218",
            "telephone_number": "423-283-0776",
            "fax_number": "423-968-5697"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 MED TECH PKWY",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376042253",
            "telephone_number": "423-610-1020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROOT",
        "first_name": "LISA",
        "middle_name": "KAY",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-08-22",
        "last_updated": "2019-04-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "TN",
            "license": "RN0000114257",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3625581",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Johnson City, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 2019; 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.