Provider Demographics
NPI:1245279777
Name:AMERICAN ANESTHESIOLOGY OF TENNESSEE, P.C.
Entity type:Organization
Organization Name:AMERICAN ANESTHESIOLOGY OF TENNESSEE, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMININSTRATOR
Authorized Official - Prefix:DR
Authorized Official - First Name:MATTHEW
Authorized Official - Middle Name:
Authorized Official - Last Name:WALSH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:516-945-3000
Mailing Address - Street 1:1305 WALT WHITMAN RD STE 300
Mailing Address - Street 2:
Mailing Address - City:MELVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:11747-4300
Mailing Address - Country:US
Mailing Address - Phone:516-945-3000
Mailing Address - Fax:844-206-2955
Practice Address - Street 1:501 20TH ST
Practice Address - Street 2:SUITE 606
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37916-1809
Practice Address - Country:US
Practice Address - Phone:865-546-8040
Practice Address - Fax:865-541-2787
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-06
Last Update Date:2025-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified RegisteredGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3604012Medicaid
TN3604012Medicaid
TNCB1124OtherMEDICARE TRAVELERS
TN029883100OtherFEDERAL BLACK LUNG
TNTN01F7OtherJOHN DEERE
TN164606500OtherUS DEPT OF LABOR
TNTN01F7OtherJOHN DEERE TENNCARE
TNCB1124OtherMEDICARE TRAVELERS