Basic Information
| Provider Information | |||||||||
| NPI: | 1811071376 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | APEX ANESTHESIA GROUP, PLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 440246 | ||||||||
| Address2: | |||||||||
| City: | NASHVILLE | ||||||||
| State: | TN | ||||||||
| PostalCode: | 372440246 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6156202320 | ||||||||
| FaxNumber: | 6156202323 | ||||||||
| Practice Location | |||||||||
| Address1: | 315 OAK ST | ||||||||
| Address2: | |||||||||
| City: | LIVINGSTON | ||||||||
| State: | TN | ||||||||
| PostalCode: | 385701728 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9318235611 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 10/24/2006 | ||||||||
| LastUpdateDate: | 05/12/2010 | ||||||||
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| AuthorizedOfficialLastName: | LEVOY | ||||||||
| AuthorizedOfficialFirstName: | JASON | ||||||||
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| AuthorizedOfficialTitleorPosition: | OWNER | ||||||||
| AuthorizedOfficialTelephone: | 9318235611 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MR. | ||||||||
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| AuthorizedOfficialCredential: | CRNA | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 367500000X | Y | 193400000X SINGLE SPECIALTY GROUP | Physician Assistants & Advanced Practice Nursing Providers | Nurse Anesthetist, Certified Registered |
ID Information
| ID | Type | State | Issuer | Description | 3635409 | 05 | TN | MEDICAID | 74901109 | 05 | KY | MEDICAID | 4111071 | 01 | TN | BC/BS OF TN NETWORKS P, S, TENNSELECT, BLUECARE | OTHER |