Individual provider Active NPI

Virginia Lee Kernodle, CRNA

  • Certified Registered Nurse Anesthetist
  • Memphis, TN
National Provider Identifier
1912087172
Registry record updated Jun 26, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
RN133007 Issued in TN
Practice address
6005 Park Ave
Suite 905 B
Memphis, TN 38119-5202
Phone
(901) 682-2872
NPI assigned
Oct 16, 2006
Last updated
Jun 26, 2013By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 26, 2013

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 RN133007 TN Primary

Addresses

Primary practice location

6005 Park Ave
Suite 905 B
Memphis, TN 38119-5202

Mailing address

3871 Prescott Rd
Memphis, TN 38118-5959
Phone (901) 494-4506

Other identifiers 1

IdentifierTypeStateIssuer
4144051OtherTNBLUE CROSS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN, MS2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20070109000592 TN Practitioner - Certified Registered Nurse Anesthetist (Crna) 4789684101 Reassigns benefits to 3 organizations
I20070724000797 MS Practitioner - Certified Registered Nurse Anesthetist (Crna) 4789684101 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Resource Anesthesiology Associates of TN PCGroup PAC ID 8527419092, 145 clinicians

Practice addresses (Care Compare)

1265 Union Ave
Suite 201
Memphis, TN 38104-3415
Phone (901) 516-7000

4250 Bethel Rd
Olive Branch, MS 38654-8737
Phone (662) 932-9000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
85.75 of 100Reported as group
Quality
83.24
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RN133007TNMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Resource Anesthesiology Associates of TN PC Nurse Anesthetist, Certified Registered CurrentSince Jul 29, 2024 Accepting new patients
Medical Anesthesia Group, PA CurrentSince Jul 31, 2023 Accepting new patients
Phillip R. Bowden, M.D.,P.a. CurrentSince Mar 31, 2014 Accepting new patients
East Memphis Anesthesia Services PLC Past Accepting new patients
Health 360 PLLC PastSince Jan 21, 2024 Accepting new patients

Locations

4250 Bethel Rd
Olive Branch, MS 38654
Phone (662) 932-9000

7580 Clarington Cv
Southaven, MS 38671
Phone (901) 259-1600

450 Mamaroneck Ave
Ste 201
Harrison, NY 10528
Phone (877) 476-6642

1265 Union Ave
Memphis, TN 38104
Phone (901) 516-2362

1265 Union Ave
Ste 201
Memphis, TN 38104
Phone (901) 516-7000

1300 Wesley Dr
Memphis, TN 38116
Phone (901) 516-3700

1417 Monroe Ave
Memphis, TN 38104
Phone (901) 272-7200

1717 Kirby Pkwy
Memphis, TN 38120
Phone (901) 272-7200

255 S Pauline St
Memphis, TN 38104
Phone (901) 261-2804

3960 New Covington Pike
Memphis, TN 38128
Phone (901) 516-5200

7691 Poplar Ave
Memphis, TN 38138
Phone (901) 516-1290

Organizations & group practices 5

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.

Hospital & facility affiliations 3

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": "1160956800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1372204800000",
    "number": "1912087172",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3871 PRESCOTT RD",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381185959",
            "telephone_number": "901-494-4506"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6005 PARK AVE",
            "address_2": "SUITE 905 B",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381195202",
            "telephone_number": "901-682-2872"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KERNODLE",
        "first_name": "VIRGINIA",
        "middle_name": "LEE",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-16",
        "last_updated": "2013-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "TN",
            "license": "RN133007",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "4144051",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Memphis, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2013; 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.