Individual provider Active NPI

Kurtis Lansdell, CRNA

  • Certified Registered Nurse Anesthetist
  • Athens, TN
National Provider Identifier
1932187234
Registry record updated Oct 26, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
9548 CRNA Issued in TN
Practice address
1114 W Madison Ave
Athens, TN 37303-4150
Phone
(423) 745-1411
NPI assigned
Jan 6, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 26, 2007

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 9548 CRNA TN Primary

Addresses

Primary practice location

1114 W Madison Ave
Athens, TN 37303-4150

Mailing address

PO Box 220
Athens, TN 37371-0220
Phone (423) 424-3695

Other identifiers 3

IdentifierTypeStateIssuer
P00367529OtherTNRR MEDICARE
3624408MedicaidTN
4129536OtherTNBLUE SHIELD BLUE SHIELD

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

State licenses

LicenseStateTypeSpecialty
46298TNMDFamily Medicine Physician
9548 CRNATNMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Community Anesthesia, PC Nurse Anesthetist, Certified Registered Past Accepting new patients
Dyersburg Hospital Company LLC Nurse Anesthetist, Certified Registered Past Accepting new patients

Organizations & group practices 2

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": "1136505600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1193356800000",
    "number": "1932187234",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 220",
            "city": "ATHENS",
            "state": "TN",
            "postal_code": "373710220",
            "telephone_number": "423-424-3695"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1114 W MADISON AVE",
            "city": "ATHENS",
            "state": "TN",
            "postal_code": "373034150",
            "telephone_number": "423-745-1411"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LANSDELL",
        "first_name": "KURTIS",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-06",
        "last_updated": "2007-10-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "TN",
            "license": "9548 CRNA",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P00367529",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3624408",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD BLUE SHIELD",
            "identifier": "4129536",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Athens, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2007; 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.