MEDICARE: ANESTHESIA SPECIALTY ASSOCIATES, INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	367500000X	Certified Registered Nurse Anesthetist

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	DB4224	OTHER	TN	RR MEDICARE-PALMETTO GBA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	01032946	OTHER	TN	AMERIGROUP TENNCARE ONLY - PAR
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1942236922
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ANESTHESIA SPECIALTY ASSOCIATES, INC

Provider Business Mailing Address
First Line	:	PO BOX 440352
Second Line	:
City	:	NASHVILLE
State	:	TN
Zip	:	37244-0352
Country	:	US
Telephone Number	:	615-620-2320
Fax Number	:	615-620-2323

Provider Business Practice Location Address
First Line	:	2835 HIGHWAY 231 N
Second Line	:
City	:	SHELBYVILLE
State	:	TN
Zip	:	37160-7327
Country	:	US
Telephone Number	:	615-620-2320
Fax Number	:	615-620-2323

Authorized Official
Title or Position	:	PARTNER
Name	:	MR. JERRY L SHERRILL
Credential	:	CRNA
Telephone Number	:	615-620-2320

Provider Enumeration Date	:	06/23/2006
Last Update Date	:	09/23/2010

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