Unknown Individual – Certified Registered Nurse Anesthetist, NPI 1043495112

Certified Registered Nurse Anesthetist

Unknown Individual is a healthcare provider. based in Talbott, Tennessee. specializing in Certified Registered Nurse Anesthetist. They hold a License No. RN0000140858 (TN). The NPI Number for Unknown Individual is 1043495112

Main info

Organization

Inactive

19 Years Of Experience

Accepts Medicare Assignment

Name

Unknown Individual

NPI

1043495112

Phone

(423) 408-2826

Address

7460 LEBANON CHURCH ROAD

Deactivation Date

15 January 2021

Doctor Profile

Medical School Name

OTHER

Secondary Phone

4232746350

Graduation Year

2007 (19 years ago)

PAC ID

4789760182

Group Practice PAC ID

4789781048

Professional Enrollment ID

I20080326000295

Data current as of

20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology

Experience23

Completeness75

Years active:0State licenses:2Digital endpointsOther names

Provider Addresses for Unknown Individual

7460 LEBANON CHURCH ROAD
TALBOTT, TN 37877
Phone: (423) 408-2826
Fax: (423) 839-2115
Type: Location
470, South Central Avenue, Church Hill, Hawkins County, Tennessee, 37642, United States
CHURCH HILL, TN 376423602
Phone: (423) 943-1143
Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

No Medicare enrollment or revalidation data available for this provider in our database.

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 37877)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.

PAC ID: 4789781048View full group profile

Name	Specialty	State
TABITHA STARR DAVIDSON (NP)	-	FL
JOHNNY LEE ESTEP (CRNA)	Certified Registered Nurse Anesthetist (Crna)	TN
LINDSEY BURRELL (FNP-BC)	Nurse Practitioner	TN
DR. DOUGLAS E HOMOKY (M.D.)	G A S T R O E N T E R O L O G Y	TN
DR. CHRISTOPHER MARK MATHEWS (M.D.)	G A S T R O E N T E R O L O G Y	TN
MR. ERIC ANDERSON (CRNA)	Certified Registered Nurse Anesthetist (Crna)	VA
TRACY J CURTIN (CRNA)	Certified Registered Nurse Anesthetist (Crna)	TN
MELISSA C HAMILTON (APRN)	Nurse Practitioner	TN
DR. JOSHUA D HALL (M.D.)	Gastroenterology, Internal Medicine	TN
BRADLEY S AVANS (CRNA)	Certified Registered Nurse Anesthetist (Crna)	TN

Reviews

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Frequently asked questions

Is Unknown Individual listed with a National Provider Identifier?

Yes — Unknown Individual has NPI 1043495112 on file in the registry.

Can Unknown Individual still bill if the NPI is inactive?

Do not rely on inactive status alone — contact the provider for confirmation.

What kind of doctor is Unknown Individual?

Unknown Individual is associated with Certified Registered Nurse Anesthetist in the directory — Clinical services aligned with this taxonomy classification.

Where in Tennessee is Unknown Individual registered?

Use Talbott, Tennessee as the headline location for Unknown Individual here.

Does Unknown Individual accept insurance?

Insurance participation is not part of the core NPI extract — call the plan or office to confirm.