Individual provider Active NPI

Deborah Carter, CRNA

  • Certified Registered Nurse Anesthetist
  • Sioux City, IA
National Provider Identifier
1073515094
Registry record updated Mar 3, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
091644 Issued in IA
Practice address
801 5TH St
Sioux City, IA 51101-1394
Phone
(712) 279-2505
NPI assigned
Aug 10, 2005
Last updated
Mar 3, 2015By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 3, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 091644 IA Primary

Addresses

Primary practice location

801 5TH St
Sioux City, IA 51101-1394

Mailing address

233 W 1St St
Waconia, MN 55387-1302
Phone (952) 442-9770

Other identifiers 2

IdentifierTypeStateIssuer
1226498MedicaidIA
30121OtherIABLUE CROSS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SD, NE2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20070521000269 SD Practitioner - Certified Registered Nurse Anesthetist (Crna) 9133226574 Reassigns benefits to 1 organization
I20200924000383 NE Practitioner - Certified Registered Nurse Anesthetist (Crna) 9133226574 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
09164IAMDGeneral Practice Dentistry
091644IAMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Siouxland Anesthesiology, LTD Nurse Anesthetist, Certified Registered CurrentSince Aug 25, 2006 Accepting new patients
Greater Siouxland Anesthesiology & Pain Prof LLC Nurse Anesthetist, Certified Registered CurrentSince Aug 1, 2020 Accepting new patients

Locations

400 10th St E
Waconia, MN 55387

201 E 4th St
South Sioux City, NE 68776
Phone (402) 412-2160

101 Tower Rd
Ste 201
North Sioux City, SD 57049
Phone (605) 232-3332

600 N Sioux Point Rd
North Sioux City, SD 57049
Phone (605) 217-4320

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1123632000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1425340800000",
    "number": "1073515094",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "233 W 1ST ST",
            "city": "WACONIA",
            "state": "MN",
            "postal_code": "553871302",
            "telephone_number": "952-442-9770",
            "fax_number": "952-442-3620"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "801 5TH ST",
            "city": "SIOUX CITY",
            "state": "IA",
            "postal_code": "511011394",
            "telephone_number": "712-279-2505"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARTER",
        "first_name": "DEBORAH",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-08-10",
        "last_updated": "2015-03-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "IA",
            "license": "091644",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1226498",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "30121",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sioux City, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.