Individual provider Active NPI

Samuel J Feltman, CRNA

  • Certified Registered Nurse Anesthetist
  • Cordova, TN
National Provider Identifier
1912919556
Registry record updated Feb 16, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
14170 Issued in TN
Practice address
1243 Ecklin Dr
Cordova, TN 38016-0414
Phone
(601) 604-1512
NPI assigned
Aug 12, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 16, 2022

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 14170 TN Primary

Addresses

Primary practice location

1243 Ecklin Dr
Cordova, TN 38016-0414

Mailing address

1243 Ecklin Dr
Cordova, TN 38016-0414
Phone (601) 604-1512

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
14170TNMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Meridian Surgery Center Past Accepting new patients
McLemore Emergency Physicians PastSince Dec 18, 2007 Accepting new patients
Meridian Crna LLC Nurse Anesthetist, Certified Registered Past Accepting new patients

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1155340800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1644969600000",
    "number": "1912919556",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1243 ECKLIN DR",
            "city": "CORDOVA",
            "state": "TN",
            "postal_code": "380160414",
            "telephone_number": "601-604-1512"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1243 ECKLIN DR",
            "city": "CORDOVA",
            "state": "TN",
            "postal_code": "380160414",
            "telephone_number": "601-604-1512"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FELTMAN",
        "first_name": "SAMUEL",
        "middle_name": "J",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-12",
        "last_updated": "2022-02-16",
        "certification_date": "2022-02-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "TN",
            "license": "14170",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cordova, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 16, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.