Individual provider Active NPI

Debra A Hoerth, CRNA

  • Certified Registered Nurse Anesthetist
  • Lebanon, MO
National Provider Identifier
1114918646
Registry record updated Mar 29, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
151783 Issued in MO
Practice address
120 Hospital Dr
Lebanon, MO 65536-9238
Phone
(417) 533-6100
NPI assigned
Nov 3, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 29, 2012

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 151783 MO Primary

Addresses

Primary practice location

120 Hospital Dr
Lebanon, MO 65536-9238

Mailing address

758 N Dogwood CT
Nixa, MO 65714-7216
Phone (503) 369-7978

Other identifiers 3

IdentifierTypeStateIssuer
P00398983OtherKSRR MEDICARE GROUP CQ2302
100381010BMedicaidKS
145411OtherKSBCBS OF KS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ, VA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20190129003381 AZ Practitioner - Certified Registered Nurse Anesthetist (Crna) 6103823158 Reassigns benefits to 3 organizations
I20230711001032 VA Practitioner - Certified Registered Nurse Anesthetist (Crna) 6103823158 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Banner Hospital Based Physicians Arizona LLCGroup PAC ID 3274782487, 636 clinicians

Practice addresses (Care Compare)

1900 N Higley Rd
Gilbert, AZ 85234-1604
Phone (480) 453-2034

Hospital & facility affiliations

  • Banner Gateway Medical Center Hospital, Gilbert, AZ, CCN 030122
  • Banner Thunderbird Medical Center Hospital, Glendale, AZ, CCN 030089

Merit-based Incentive Payment System (MIPS)

Final score
83.7 of 100Reported as group
Quality
64.97
Promoting interoperability
98
Improvement activities
40
Cost
69.88

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
151783MOMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Gateway Anesthesia and Pain Associates PLLC Nurse Anesthetist, Certified Registered CurrentSince Aug 5, 2018 Accepting new patients
Banner Hospital Based Physicians Arizona LLC Current Accepting new patients
Banner Hospital Based Physicians Arizona LLC CurrentSince Nov 1, 2024 Accepting new patients
Grand Canyon Anesthesia LLC Nurse Anesthetist, Certified Registered CurrentSince Jan 21, 2020 Accepting new patients
Banner Hospital Based Physicians Arizona LLC CurrentSince Nov 1, 2024 Accepting new patients
Anesthesia Consulting Services, PA Past Accepting new patients
Frances Mahon Deaconess Hospital Past Accepting new patients
Ozark Anesthesia Associates, Inc. PastSince Jun 17, 2002 Accepting new patients
Pacific County Hospital District 2 PastSince Aug 1, 2012 Accepting new patients
Yakima Hma Physician Management LLC Past Accepting new patients
Pacific County Hospital District 2 Past Accepting new patients
St John'S Regional Medical Center Nurse Anesthetist, Certified Registered Past Accepting new patients
St Johns Regional Medical Center Nurse Anesthetist, Certified Registered Past Accepting new patients

Locations

2680 S Val Vista Dr
Ste 127
Gilbert, AZ 85295
Phone (480) 253-5656

1900 N Higley Rd
Gilbert, AZ 85234
Phone (480) 543-2000

18699 N 67th Ave
Ste 140
Glendale, AZ 85308
Phone (623) 376-8600

1500 S Dobson Rd
Ste 101
Mesa, AZ 85202
Phone (480) 306-6098

2345 E Thomas Rd
Ste 400
Phoenix, AZ 85016
Phone (602) 343-2900

1111 E McDowell Rd
Phoenix, AZ 85006
Phone (602) 239-2000

Organizations & group practices 14

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.

View all 14

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1130976000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1332979200000",
    "number": "1114918646",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "758 N DOGWOOD CT",
            "city": "NIXA",
            "state": "MO",
            "postal_code": "657147216",
            "telephone_number": "503-369-7978"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 HOSPITAL DR",
            "city": "LEBANON",
            "state": "MO",
            "postal_code": "655369238",
            "telephone_number": "417-533-6100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOERTH",
        "first_name": "DEBRA",
        "middle_name": "A",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-11-03",
        "last_updated": "2012-03-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MO",
            "license": "151783",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE GROUP CQ2302",
            "identifier": "P00398983",
            "state": "KS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100381010B",
            "state": "KS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF KS",
            "identifier": "145411",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lebanon, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 2012; 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.