Individual provider Active NPI

Elizabeth Jennifer Cameron, CRNA

  • Certified Registered Nurse Anesthetist
  • Dallas, TX
National Provider Identifier
1104888197
Registry record updated Aug 18, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
53761 Issued in TX
Practice address
7 Medical Pkwy
Dallas, TX 75234-7829
Phone
(855) 677-8669
Fax
(888) 510-3225
NPI assigned
Apr 5, 2006
Last updated
Aug 18, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 18, 2020

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 53761 TX Primary

Addresses

Primary practice location

7 Medical Pkwy
Dallas, TX 75234-7829

Mailing address

145 Shawnee TRL
Celina, TX 75009-2380
Phone (972) 787-8152

Other identifiers 3

IdentifierTypeStateIssuer
2810OtherCANURSE ANESTHETIST CERT. #
53761OtherTXNBCRNA
AP117888OtherTXTEXAS BOARD OF NURSING

Other names 1

  • Teri E Mraule Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090804000874 TX Practitioner - Certified Registered Nurse Anesthetist (Crna) 8527041169 Reassigns benefits to 2 organizations
Practice locations: Sherman, TX

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
53761TXMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Endo Sedation LLC Nurse Anesthetist, Certified Registered CurrentSince Nov 26, 2012 Accepting new patients
Endo Sedation LLC Nurse Anesthetist, Certified Registered CurrentSince Nov 26, 2012 Accepting new patients
Noble Anesthesia Partners, PLLC CurrentSince Jun 1, 2020 Accepting new patients
Akshay Vakharia M.D.,PLLC Past Accepting new patients
Specialists in Advanced Gastroenterology and Endoscopy, PLLC Past Accepting new patients
Denton Anesthesiology Associates, PA Nurse Anesthetist, Certified Registered Past Accepting new patients
Surgical Anesthesia Services of California Past Accepting new patients

Locations

9101 N Central Expy
Ste 550
Dallas, TX 75231
Phone (214) 442-0055

1620 N Mesa St
El Paso, TX 79902
Phone (210) 660-5040

7 Medical Pkwy
Farmers Brnch, TX 75234
Phone (972) 247-1000

1001 Surrey Ln
Flower Mound, TX 75022
Phone (817) 337-3671

7200 Oakmont Blvd
Fort Worth, TX 76132
Phone (817) 732-3300

180 Bear Creek Pkwy
Keller, TX 76248
Phone (817) 337-3671

Organizations & group practices 7

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": "1144195200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1597708800000",
    "number": "1104888197",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "145 SHAWNEE TRL",
            "city": "CELINA",
            "state": "TX",
            "postal_code": "750092380",
            "telephone_number": "972-787-8152"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7 MEDICAL PKWY",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752347829",
            "telephone_number": "855-677-8669",
            "fax_number": "888-510-3225"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAMERON",
        "first_name": "ELIZABETH",
        "middle_name": "JENNIFER",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-05",
        "last_updated": "2020-08-18",
        "certification_date": "2020-08-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "TX",
            "license": "53761",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NURSE ANESTHETIST CERT. #",
            "identifier": "2810",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NBCRNA",
            "identifier": "53761",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TEXAS BOARD OF NURSING",
            "identifier": "AP117888",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TERI",
            "last_name": "MRAULE",
            "middle_name": "E",
            "credential": "CRNA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Dallas, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2020; 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.