Tevis Clark Smith, CRNA, RN

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

119117 Issued in KY

Practice address

250 Park St
Bowling Green, KY 42101-1760

Phone

(270) 745-1000

NPI assigned

Dec 14, 2017

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in KY

Enrollment records 1

Specialty

Certified Registered Nurse Anesthetist (Crna)

Education

Other, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Commonwealth Health Corporation, Inc.Group PAC ID 5496667628, 268 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• The Medical Center (Bowling Green) Hospital, Bowling Green, KY, CCN 180013

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Registered Nurse, Registered Nurse

State licenses

Practice roles

Locations

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.

• Commonwealth Health Corporation, Inc

  • Neurology Physician
  • Bowling Green, KY
  • NPI 1881109304

  Single Specialty

  Medicare reassignment Care Compare group NPD
• Commonwealth Health Corporation, Inc

  • Surgery Physician
  • Albany, KY
  • NPI 1922539188
  NPD
• Commonwealth Health Corporation, Inc.

  • Plastic and Reconstructive Surgery Physician
  • Bowling Green, KY
  • NPI 1104470699
  NPD

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

• Bowling Green-Warren County Community Hospital Corporation

  • General Acute Care Hospital
  • Bowling Green, KY
  • NPI 1043293608
  Care Compare affiliation

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

{
    "created_epoch": "1513209600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1513209600000",
    "number": "1902312804",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "680 RALPH MORRIS RD",
            "city": "GLASGOW",
            "state": "KY",
            "postal_code": "421419647",
            "telephone_number": "270-670-5267"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "250 PARK ST",
            "city": "BOWLING GREEN",
            "state": "KY",
            "postal_code": "421011760",
            "telephone_number": "270-745-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "TEVIS",
        "middle_name": "CLARK",
        "credential": "CRNA, RN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-12-14",
        "last_updated": "2017-12-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "KY",
            "license": "119117",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Megan Smith
• Mercedes Breyanna Smith
• Michael Smith, KCSA
• Parker Riley Smith, PMHNP-BC
• Steven Smith, M.D.
• Whitney Smith, CASE MANAGER
• Jordan Paige Smithson, OTR/L
• SMR Southern Kentucky, LLC
• SMR Southern Kentucky, LLC
• Cody Sneed, RBT

• Certified Registered Nurse Anesthetist in Bowling Green, KY
• Providers in Bowling Green, KY by specialty
• Certified Registered Nurse Anesthetist in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 14, 2017; 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.