Individual provider Active NPI

Deborah K Johnson

  • Certified Registered Nurse Anesthetist
  • Tarboro, NC
National Provider Identifier
1184957516
Registry record updated May 27, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
083018 Issued in NC
Practice address
111 Hospital Dr
Tarboro, NC 27886-2011
Phone
(252) 641-7229
Fax
(252) 641-7388
NPI assigned
Sep 17, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 27, 2010

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 65826 NC
Certified Registered Nurse Anesthetist 367500000X 083018 NC Primary

Addresses

Primary practice location

111 Hospital Dr
Tarboro, NC 27886-2011

Mailing address

360 Corbett Rd
Goldsboro, NC 27534-7910
Phone (919) 778-0140

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100211000775 NC Practitioner - Certified Registered Nurse Anesthetist (Crna) 4880737972 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Carolinaeast Medical CenterGroup PAC ID 1557272564, 67 clinicians

Practice addresses (Care Compare)

2000 Neuse Blvd
New Bern, NC 28560-3449
Phone (252) 633-8111

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
083018NCMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Carolinaeast Medical Center Nurse Anesthetist, Certified Registered CurrentSince Aug 1, 2013 Accepting new patients
Carolinaeast Medical Center CurrentSince Aug 1, 2013 Accepting new patients

Locations

2000 Neuse Blvd
New Bern, NC 28560
Phone (252) 633-8104

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 and National Provider Directory roles.

Hospital & facility affiliations 1

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": "1253145600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1274918400000",
    "number": "1184957516",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "360 CORBETT RD",
            "city": "GOLDSBORO",
            "state": "NC",
            "postal_code": "275347910",
            "telephone_number": "919-778-0140"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 HOSPITAL DR",
            "city": "TARBORO",
            "state": "NC",
            "postal_code": "278862011",
            "telephone_number": "252-641-7229",
            "fax_number": "252-641-7388"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "DEBORAH",
        "middle_name": "K",
        "name_prefix": "Ms.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-09-17",
        "last_updated": "2010-05-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NC",
            "license": "65826",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "NC",
            "license": "083018",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tarboro, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 27, 2010; 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.