Provider Demographics
NPI:1366624967
Name:MERIT ANESTHESIA PLLC
Entity Type:Organization
Organization Name:MERIT ANESTHESIA PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:KLAPPHOLZ
Authorized Official - Suffix:
Authorized Official - Credentials:CRNA
Authorized Official - Phone:865-385-9043
Mailing Address - Street 1:PO BOX 23343
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37933-1343
Mailing Address - Country:US
Mailing Address - Phone:630-733-1796
Mailing Address - Fax:630-599-1317
Practice Address - Street 1:9918 CORAL SPRINGS LN
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37922-3468
Practice Address - Country:US
Practice Address - Phone:423-639-0941
Practice Address - Fax:423-638-3401
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-05
Last Update Date:2020-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
207L00000X
TN0000010225367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified RegisteredGroup - Single Specialty
No207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN1509153OtherTENNCARE MEDICARE
TNDO2065OtherRAILROAD MEDICARE
4162599OtherBCBS
4162599OtherBCBS
SC9477Medicare PIN