Individual provider Active NPI

Michael C McConnell, CRNA

  • Certified Registered Nurse Anesthetist
  • Memphis, TN
National Provider Identifier
1962460998
Registry record updated Jun 9, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
9302 Issued in TN
Practice address
1407 Union Ave
Suite 200
Memphis, TN 38104-3600
Phone
(901) 866-8813
Fax
(901) 302-2120
NPI assigned
May 1, 2006
Last updated
Jun 9, 2011By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 9, 2011

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 9302 TN Primary

Addresses

Primary practice location

1407 Union Ave
Suite 200
Memphis, TN 38104-3600

Mailing address

1407 Union Ave
Suite 640
Memphis, TN 38104-3627
Phone (901) 866-8360

Other identifiers 9

IdentifierTypeStateIssuer
0116747OtherMSMEDICAID W/MAA
3607660OtherTNMEDICAID W/MAA
4010460OtherTNBLUE CROSS W/MAA
430056979OtherTNRAILROAD MEDICARE W/MAA
915066112OtherMOMEDICAID W/MAA
3607663OtherTNMEDICARE W/MAA
136280701OtherARMEDICAID W/MAA
3607664MedicaidTN
98469OtherARBLUE CROSS W/MAA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040802001625 TN Practitioner - Certified Registered Nurse Anesthetist (Crna) 1456322650 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

6019 Walnut Grove Rd
Memphis, TN 38120-2113
Phone (901) 226-5000

6225 Humphreys Blvd
Memphis, TN 38120-2373
Phone (904) 227-9000

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

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
80.97 of 100Reported as group
Quality
64.58
Improvement activities
40
Cost
77.33

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
9302TNMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Ut Regional One Physicians Inc Nurse Anesthetist, Certified Registered Current Accepting new patients
Ut Regional One Physicians Inc Nurse Anesthetist, Certified Registered CurrentSince Sep 1, 2014 Accepting new patients
American Anesthesiology of Tennessee, P.C. CurrentSince Jan 1, 2015 Accepting new patients
Anesthesia Solutions LLC Nurse Anesthetist, Certified Registered CurrentSince Apr 15, 2021 Accepting new patients
Lifelinc Anesthesia, PLLC Nurse Anesthetist, Certified Registered CurrentSince May 1, 2019 Accepting new patients
Anesthesia Partners PLLC Nurse Anesthetist, Certified Registered Past Accepting new patients
Ridge Lake Anesthesia Nurse Anesthetist, Certified Registered Past Accepting new patients

Locations

400 10th St E
Waconia, MN 55387

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

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

1407 Union Ave
Ste 200
Memphis, TN 38104
Phone (901) 866-8360

2200 Union Ave
Memphis, TN 38104
Phone (901) 274-5813

6019 Walnut Grove Rd
Memphis, TN 38120
Phone (901) 226-3190

6485 Poplar Ave
Memphis, TN 38119
Phone (901) 767-3937

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

Organizations & group practices 7

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.

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": "1146441600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1307577600000",
    "number": "1962460998",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1407 UNION AVE",
            "address_2": "SUITE 640",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381043627",
            "telephone_number": "901-866-8360",
            "fax_number": "901-302-2360"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1407 UNION AVE",
            "address_2": "SUITE 200",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381043600",
            "telephone_number": "901-866-8813",
            "fax_number": "901-302-2120"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCONNELL",
        "first_name": "MICHAEL",
        "middle_name": "C",
        "name_prefix": "Mr.",
        "credential": "CRNA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-01",
        "last_updated": "2011-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "TN",
            "license": "9302",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAID W/MAA",
            "identifier": "0116747",
            "state": "MS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAID W/MAA",
            "identifier": "3607660",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS W/MAA",
            "identifier": "4010460",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE W/MAA",
            "identifier": "430056979",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAID W/MAA",
            "identifier": "915066112",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE W/MAA",
            "identifier": "3607663",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAID W/MAA",
            "identifier": "136280701",
            "state": "AR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3607664",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS W/MAA",
            "identifier": "98469",
            "state": "AR"
        }
    ],
    "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 9, 2011; 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.