NPIMap

Organization Active NPI

Anesthesia Care of Tullahoma, P.C.

  • Anesthesiology Physician
  • Tullahoma, TN
National Provider Identifier
1902849607
Registry record updated Apr 1, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
Legal business name
ANESTHESIA CARE OF TULLAHOMA, P.C.
Practice address
106 W Blackwell St
Tullahoma, TN 37388-3556
Phone
(931) 454-9810
Fax
(931) 393-1020
NPI assigned
Jun 13, 2006
Last updated
Apr 1, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 1, 2022

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

Authorized official

Name
Dr. Kevin M GilesNPI 1861531899
Title
Owner
Phone
(931) 454-9810

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207L00000X INDIVIDUAL PRACTIONE TN
Anesthesiology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207L00000X Primary
Certified Registered Nurse AnesthetistGroup: 193200000X MULTI-SPECIALTY GROUP 367500000X

Addresses

Primary practice location

106 W Blackwell St
Tullahoma, TN 37388-3556

Mailing address

PO Box 415000-Msc8337
Nashville, TN 37241-8337
Phone (865) 670-6199

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031113000214 TN Part B Supplier - Clinic/Group Practice 4385558543 Receives reassigned benefits from 4 practitioners
Practice locations: Tullahoma, TN

National Provider Directory

National Provider Directory

Locations

106 W Blackwell St
Tullahoma, TN 37388
Phone (931) 222-4626

1816 N Washington St
Ste 103
Tullahoma, TN 37388
Phone (931) 454-9810

Practitioners & affiliated clinicians

Practitioners 19

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 19

NPI Registry JSON

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

{
    "created_epoch": "1150156800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1648771200000",
    "number": "1902849607",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 415000-MSC8337",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372418337",
            "telephone_number": "865-670-6199",
            "fax_number": "865-670-6198"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "106 W BLACKWELL ST",
            "city": "TULLAHOMA",
            "state": "TN",
            "postal_code": "373883556",
            "telephone_number": "931-454-9810",
            "fax_number": "931-393-1020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ANESTHESIA CARE OF TULLAHOMA, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-13",
        "last_updated": "2022-04-01",
        "certification_date": "2022-04-01",
        "status": "A",
        "authorized_official_last_name": "GILES",
        "authorized_official_first_name": "KEVIN",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "931-454-9810",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Anesthesiology",
            "state": "TN",
            "license": "INDIVIDUAL PRACTIONE",
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Anesthesiology",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "367500000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tullahoma, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.