Individual provider Active NPI

Hunter Christian Gough, CRNA

  • Certified Registered Nurse Anesthetist
  • Memphis, TN
National Provider Identifier
1952921256
Registry record updated Jun 23, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
27695 Issued in TN
Practice address
877 Jefferson Ave
Memphis, TN 38103-2807
Phone
(901) 545-7100
NPI assigned
Apr 16, 2020
Last updated
Jun 23, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 23, 2020

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 27695 TN Primary
Critical Care Medicine Registered Nurse 163WC0200X 0000208404 TN

Addresses

Primary practice location

877 Jefferson Ave
Memphis, TN 38103-2807

Mailing address

726 Mann Cir E Apt 112
Memphis, TN 38103-4543
Phone (270) 313-8623

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200630000840 TN Practitioner - Certified Registered Nurse Anesthetist (Crna) 9830511302 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
University of Tennessee, HSC, College of Medicine, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Midsouth Speciality Anesthesia Services LLCGroup PAC ID 6103293667, 29 clinicians

Practice addresses (Care Compare)

1750 Madison Ave
Suite 300
Memphis, TN 38104-6428
Phone (901) 390-2930

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0000208404TNMDCritical Care Medicine Registered Nurse
27695TNMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Ut Regional One Physicians Inc Nurse Anesthetist, Certified Registered Current Accepting new patients
Midsouth Speciality Anesthesia Services LLC Nurse Anesthetist, Certified Registered CurrentSince Nov 1, 2022 Accepting new patients
Ut Regional One Physicians Inc Nurse Anesthetist, Certified Registered CurrentSince Jul 21, 2020 Accepting new patients
East Memphis Anesthesia Services PLC CurrentSince Jun 27, 2023 Accepting new patients

Locations

2986 Kate Bond Rd
Bartlett, TN 38133
Phone (901) 765-1000

1355 W Brierbrook Rd
Germantown, TN 38138
Phone (901) 755-8300

1750 Madison Ave
Ste 300
Memphis, TN 38104
Phone (901) 725-7025

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

825 Ridge Lake Blvd
Memphis, TN 38120
Phone (901) 685-6150

877 Jefferson Ave
Memphis, TN 38103
Phone (901) 448-5893

3301 S 14th St
Ste 16180
Abilene, TX 79605

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1586995200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1592870400000",
    "number": "1952921256",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "726 MANN CIR E APT 112",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381034543",
            "telephone_number": "270-313-8623"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "877 JEFFERSON AVE",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381032807",
            "telephone_number": "901-545-7100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOUGH",
        "first_name": "HUNTER",
        "middle_name": "CHRISTIAN",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-04-16",
        "last_updated": "2020-06-23",
        "certification_date": "2020-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "TN",
            "license": "27695",
            "primary": true
        },
        {
            "code": "163WC0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Critical Care Medicine",
            "state": "TN",
            "license": "0000208404",
            "primary": false
        }
    ],
    "identifiers": [],
    "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 23, 2020; 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.