Individual provider Active NPI

Taryn E. Fairbanks, CRNA

  • Certified Registered Nurse Anesthetist
  • Chattanooga, TN
National Provider Identifier
1912201039
Registry record updated Sep 29, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
APN15431 Issued in TN
Practice address
2341 McCallie Ave
Suite 402
Chattanooga, TN 37404-3239
Phone
(423) 698-3309
Fax
(423) 624-6355
NPI assigned
Jan 4, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 29, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X RN148026 TN
Certified Registered Nurse Anesthetist 367500000X APN15431 TN Primary

Addresses

Primary practice location

2341 McCallie Ave
Suite 402
Chattanooga, TN 37404-3239

Mailing address

PO Box 3549
Chattanooga, TN 37404-0549
Phone (423) 698-3309

Other identifiers 3

IdentifierTypeStateIssuer
4284390OtherTNBLUE CROSS BLUE SHIELD OF TN
1522298MedicaidTN
P00904219OtherRAILROAD MEDICARE

Other names 1

  • Taryn E Hickman Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110217000115 TN Practitioner - Certified Registered Nurse Anesthetist (Crna) 7810178373 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sda Consultants PLLCGroup PAC ID 3870825912, 76 clinicians
American Anesthesiology of Tennessee PCGroup PAC ID 9931001922, 296 clinicians

Practice addresses (Care Compare)

137 25TH St NE
Cleveland, TN 37311-3944
Phone (423) 472-7874

2333 McCallie Ave
Chattanooga, TN 37404-3258
Phone (865) 546-8040

9300 Park W Blvd
Knoxville, TN 37923-4301
Phone (865) 546-8040

941 Spring Creek Rd
Chattanooga, TN 37412-3909
Phone (865) 546-8040

Hospital & facility affiliations

  • Parkridge Medical Center Hospital, Chattanooga, TN, CCN 440156

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
American Anesthesiology of Tennessee, P.C. CurrentSince Apr 1, 2013 Accepting new patients
Sweet Dreams Anesthesia Inc Nurse Anesthetist, Certified Registered CurrentSince Jan 1, 2020 Accepting new patients
American Anesthesiology of Tennessee, P.C. Nurse Anesthetist, Certified Registered CurrentSince Apr 1, 2013 Accepting new patients
Sda Consultants PLLC Nurse Anesthetist, Certified Registered CurrentSince Apr 26, 2024 Accepting new patients
Anesthesiologists Associated PC Past Accepting new patients
Anesthesiologists Associated PC Nurse Anesthetist, Certified Registered Past Accepting new patients

Locations

2525 Desales Ave
Chattanooga, TN 37404
Phone (423) 495-2620

2515 Desales Ave
Chattanooga, TN 37404
Phone (423) 648-6672

2358 Lifestyle Way
Chattanooga, TN 37421

4601 Carothers Pkwy
Ste 375
Franklin, TN 37067
Phone (615) 791-4790

9300 Park West Blvd
Knoxville, TN 37923
Phone (865) 427-4040

501 20th St
Ste 606
Knoxville, TN 37916
Phone (865) 331-2278

28 White Bridge Pike
Ste 210
Nashville, TN 37205
Phone (615) 352-3000

Organizations & group practices 6

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": "1294099200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1632873600000",
    "number": "1912201039",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3549",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374040549",
            "telephone_number": "423-698-3309",
            "fax_number": "423-624-6355"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2341 MCCALLIE AVE",
            "address_2": "SUITE 402",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374043239",
            "telephone_number": "423-698-3309",
            "fax_number": "423-624-6355"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAIRBANKS",
        "first_name": "TARYN",
        "middle_name": "E.",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-01-04",
        "last_updated": "2021-09-29",
        "certification_date": "2021-09-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "TN",
            "license": "RN148026",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "TN",
            "license": "APN15431",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD OF TN",
            "identifier": "4284390",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1522298",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00904219",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TARYN",
            "last_name": "HICKMAN",
            "middle_name": "E",
            "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 Sep 29, 2021; 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.