Provider Demographics
NPI:1881728178
Name:ANESTHESIA SERVICES ASSOCIATES PLLC
Entity type:Organization
Organization Name:ANESTHESIA SERVICES ASSOCIATES PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:PETER
Authorized Official - Middle Name:
Authorized Official - Last Name:KROLL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:615-824-3737
Mailing Address - Street 1:PO BOX 440210
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37244-0210
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2175 CHAMBLISS AVE NW
Practice Address - Street 2:SUITE D
Practice Address - City:CLEVELAND
Practice Address - State:TN
Practice Address - Zip Code:37311
Practice Address - Country:US
Practice Address - Phone:423-472-1140
Practice Address - Fax:423-339-2242
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-16
Last Update Date:2018-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
332B00000X
TNAPN0000013203363LA2200X
TN174400000X
TNMD000009519207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
Yes332B00000XSuppliersDurable Medical Equipment & Medical SuppliesGroup - Multi-Specialty
No363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult HealthGroup - Multi-Specialty
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN5945250001Medicare NSC
5945250001Medicare NSC
TN3721382Medicare PIN
TN3721382Medicaid
TN5945250001Medicare Oscar/Certification
TN5945250001Medicare PIN
3370048Medicare PIN
TN5945250001Medicare Oscar/Certification
TN5945250001Medicare PIN