Autumn Samantha Longworth, CRNA is a medicare enrolled "Nurse Anesthetist, Certified Registered" in Blountville, Tennessee. She graduated from nursing school in 2019 and has 5 years of diverse experience with area of expertise as Certified Registered Nurse Anesthetist (crna). She is a member of the group practice Advanced Anesthesia Solutions Inc and her current practice location is
273 Wine Cir, Blountville, Tennessee. You can reach out to her office (for appointments etc.) via phone at
(423) 416-1678.
Autumn Samantha Longworth is licensed to practice in Virginia (license number 0024177740) and she also participates in the medicare program. She
accepts medicare assignments (which means she accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and her NPI Number is 1386204329.
Provider's Profile
| Full Name | Autumn Samantha Longworth |
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| Gender | Female |
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| Speciality | Certified Registered Nurse Anesthetist (crna) |
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| Experience | 5 Years |
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| Location | 273 Wine Cir, Blountville, Tennessee |
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| Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
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Medical Education and Training:
- Autumn Samantha Longworth graduated from nursing school in 2019
NPI Data:
- NPI Number: 1386204329
- Provider Enumeration Date: 06/20/2019
- Last Update Date: 12/15/2023
Medicare PECOS Information:
- PECOS PAC ID: 4880921121
- Enrollment ID: I20200803001628
Medical Identifiers
Medical identifiers for Autumn Samantha Longworth such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1386204329 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 367500000X | Nurse Anesthetist, Certified Registered | 0024177740 (Virginia) | Primary |
Group Practice Association
| Group Practice Name | Group PECOS PAC ID | No. of Members |
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| Advanced Anesthesia Solutions Inc | 7315200664 | 28 |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Autumn Samantha Longworth allows following entities to bill medicare on her behalf.
| Entity Name | Gastroenterology Associates |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1770578270
PECOS PAC ID: 4789781048
Enrollment ID: O20070924000124 |
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| Entity Name | Advanced Anesthesia Solutions Inc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1164772109
PECOS PAC ID: 7315200664
Enrollment ID: O20180419000153 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Autumn Samantha Longworth is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
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Autumn Samantha Longworth, CRNA
Dept 888618,
Knoxville, TN 37995-0001
Ph: (423) 915-9942 | Autumn Samantha Longworth, CRNA
273 Wine Cir,
Blountville, TN 37617-4315
Ph: (423) 416-1678 |
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