Active NPI
Samuel J Feltman, CRNA
- Certified Registered Nurse Anesthetist
- Cordova, TN
National Provider Identifier
1912919556
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Certified Registered Nurse Anesthetist
- License
- 14170
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| License | State | Type | Specialty |
|---|---|---|---|
| 14170 | TN | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Meridian Surgery Center | Past | Accepting new patients | |
| McLemore Emergency Physicians | Past | 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.
-
- Emergency Medicine Physician
- Meridian, MS
- NPI 1427007483
-
- Certified Registered Nurse Anesthetist
- Meridian, MS
- NPI 1326050790
Nurse Anesthetist, Certified Registered
-
- Ambulatory Fertility Facility
- Meridian, MS
- NPI 1366833717
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.