Mary Jean Detchemendy, CRNA

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

096193 Issued in NC

Practice address

920 Church St N
Concord, NC 28025-2927

Phone

(704) 783-4235

Fax

(704) 783-2527

NPI assigned

Jul 25, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NC

Enrollment records 1

Specialty

Certified Registered Nurse Anesthetist (Crna)

Education

Other, 1990

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Mountain Regional Anesthesia, PLLCGroup PAC ID 1557694650, 4 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Registered Nurse

State licenses

Practice roles

Locations

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

• Mountain Regional Anesthesia PLLC

  • Anesthesiology Physician
  • Franklin, NC
  • NPI 1801360565
  Medicare reassignment Care Compare group NPD
• The Charlotte-Mecklenburg Hospital Authority

  • Medical Oncology Physician
  • Indian Land, SC
  • NPI 1669738829

  NC

  Medicare reassignment NPD
• The Charlotte-Mecklenburg Hospital Authority

  • Certified Registered Nurse Anesthetist
  • Concord, NC
  • NPI 1437584653

  Nurse Anesthetist, Certified Registered

  NPD
• The Charlotte-Mecklenburg Hospital Authority

  • Rehabilitation Hospital Unit
  • Charlotte, NC
  • NPI 1962987131
  NPD
• CMC-Northeast, Inc.

  • Certified Registered Nurse Anesthetist
  • Concord, NC
  • NPI 1023105905

  Nurse Anesthetist, Certified Registered

  NPD (past)
• The Charlotte-Mecklenburg Hospital Authority

  • General Practice Physician
  • Concord, NC
  • NPI 1265754915
  NPD (past)

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

{
    "created_epoch": "1153785600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1093737009",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "102 HARBORGATE CT",
            "city": "CORNELIUS",
            "state": "NC",
            "postal_code": "280315000",
            "telephone_number": "704-892-8372"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "920 CHURCH ST N",
            "city": "CONCORD",
            "state": "NC",
            "postal_code": "280252927",
            "telephone_number": "704-783-4235",
            "fax_number": "704-783-2527"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DETCHEMENDY",
        "first_name": "MARY",
        "middle_name": "JEAN",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-25",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "NC",
            "license": "096193",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8050167",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Anna Ingeborg Depaulis, MD
• Dermatology Group of the Carolinas
• Mark S Dermer, MD
• Rhode Desauguste, PMHNP
• Cynthia Cheung Desilva, RPH
• Tashana Detwiler, DMD
• Mary Elizabeth Devlin
• Tiffany Moore Dewitt, CRNA
• Jeremy Dewolf, PA-C
• Diana'S Homecare, Inc

• Certified Registered Nurse Anesthetist in Concord, NC
• Providers in Concord, NC by specialty
• Certified Registered Nurse Anesthetist in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.