Individual provider Active NPI

Deborah Anne Cleary, CRNA

  • Certified Registered Nurse Anesthetist
  • Jbsa Lackland, TX
National Provider Identifier
1013986306
Registry record updated Aug 21, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
576531 Issued in TX
Practice address
1100 Wilford Hall Loop, BLDG 4554
Attn: 59 MDW/SGHC
Jbsa Lackland, TX 78236-9908
Phone
(210) 542-7563
NPI assigned
Mar 17, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 21, 2019

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X AP114267 TX
Certified Registered Nurse Anesthetist 367500000X 576531 TX Primary

Addresses

Primary practice location

1100 Wilford Hall Loop, BLDG 4554
Attn: 59 MDW/SGHC
Jbsa Lackland, TX 78236-9908

Mailing address

584 County Road 543
Hondo, TX 78861-5657
Phone (210) 542-7563

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
576531TXMDCertified Registered Nurse Anesthetist
AP114267TXMDCertified Registered Nurse Anesthetist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1142553600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1566345600000",
    "number": "1013986306",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "584 COUNTY ROAD 543",
            "city": "HONDO",
            "state": "TX",
            "postal_code": "788615657",
            "telephone_number": "210-542-7563"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 WILFORD HALL LOOP, BLDG 4554",
            "address_2": "ATTN: 59 MDW/SGHC",
            "city": "JBSA LACKLAND",
            "state": "TX",
            "postal_code": "782369908",
            "telephone_number": "210-542-7563"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLEARY",
        "first_name": "DEBORAH",
        "middle_name": "ANNE",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-17",
        "last_updated": "2019-08-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "TX",
            "license": "AP114267",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "TX",
            "license": "576531",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jbsa Lackland, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.