Donald E Chamberlain, CRNA

Individual provider Active NPI Certified Registered Nurse Anesthetist · Sparta, TN

NPI 1992744171 · NPPES record last updated Jul 30, 2010

Key facts

NPI
1992744171
Entity type
Individual (NPI type 1)
Primary specialty
Certified Registered Nurse Anesthetist 367500000X
License
APN 011520 (TN)
Practice address
401 Sewell Dr
Sparta, TN 38583-1223
Phone
(615) 620-2320
Fax
(615) 620-2323
NPI assigned
Jun 5, 2006
Sex
Male
Sole proprietor
No

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.

Medicare participation

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

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
11520TNMDSocial Worker
RN047828TNMDRegistered Nurse
33486TNMDNurse Practitioner
APN 011520TNMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Neurosurgical Anesthesiologist,PLC Past Accepting new patients
Lynn H Jones Mid South Anesthesia Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X APN 011520 TN Yes
Registered Nurse 163W00000X RN047828 TN

Addresses

Primary practice location

401 Sewell Dr
Sparta, TN 38583-1223

Mailing address

PO Box 440167
Nashville, TN 37244-0167
Phone (615) 620-2320

Other identifiers

IdentifierTypeStateIssuer
01069113OtherTNAMERIGROUP TENNCARE - NON PAR
4168754OtherTNBLUE CROSS/BLUE SHIELD OF TN - AERO
3601605MedicaidTN
9638982MedicaidWA

Other providers in Sparta, TN

All providers in Sparta, TN · Certified Registered Nurse Anesthetist in Tennessee

Sources for this page

Verify at the official NPI Registry.