Individual provider Active NPI

Laura Beth Moreland

  • Certified Registered Nurse Anesthetist
  • Chattanooga, TN
National Provider Identifier
1891575015
Registry record updated Oct 17, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
148428 Issued in TN
Practice address
975 E 3Rd St
Chattanooga, TN 37403-2173
Phone
(423) 602-8400
Fax
(423) 602-8401
NPI assigned
Oct 4, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 17, 2023

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 148428 TN Primary

Addresses

Primary practice location

975 E 3Rd St
Chattanooga, TN 37403-2173

Mailing address

PO Box 2930
Indianapolis, IN 46206-2930
Phone (866) 282-7905

Other names 1

  • Laura Beth Kennelly Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231030003624 TN Practitioner - Certified Registered Nurse Anesthetist (Crna) 9133575970 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Anesthesiology Consultants Exchange, PCGroup PAC ID 2365434297, 152 clinicians

Practice addresses (Care Compare)

975 E 3Rd St
Chattanooga, TN 37403-2173
Phone (423) 602-8400

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
148428TNMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Anesthesiology Consultants Exchange, PC Nurse Anesthetist, Certified Registered CurrentSince Oct 4, 2023 Accepting new patients

Locations

975 E 3rd St
Chattanooga, TN 37403
Phone (423) 266-1499

979 E 3rd St
Ste C235
Chattanooga, TN 37403
Phone (423) 602-8400

Organizations & group practices 1

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": "1696377600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1697500800000",
    "number": "1891575015",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2930",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462062930",
            "telephone_number": "866-282-7905",
            "fax_number": "855-630-1300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "975 E 3RD ST",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374032173",
            "telephone_number": "423-602-8400",
            "fax_number": "423-602-8401"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MORELAND",
        "first_name": "LAURA",
        "middle_name": "BETH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-10-04",
        "last_updated": "2023-10-17",
        "certification_date": "2023-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "TN",
            "license": "148428",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LAURA",
            "last_name": "KENNELLY",
            "middle_name": "BETH",
            "credential": "CRNA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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 17, 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.