Individual provider Active NPI

Dana Claire Clevenger, CRNA

  • Nurse Practitioner
  • Ozark, MO
National Provider Identifier
1245456649
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
101627 Issued in MO
Practice address
1006 W Cory St
Ozark, MO 65721-6403
Phone
(417) 581-8720
Fax
(417) 581-8720
NPI assigned
Apr 17, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 101627 MO Primary

Addresses

Primary practice location

1006 W Cory St
Ozark, MO 65721-6403

Mailing address

1006 W Cory St
Ozark, MO 65721-6403
Phone (417) 581-8720

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
101627MOMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Mid-Continent Anesthesiology Chartered Past Accepting new patients
Central Kansas Anesthesia PA Past Accepting new patients
Watchcare Anesthesia, Inc. PastSince Jul 23, 2016 Accepting new patients
Ozarks Medical Center Past Accepting new patients
Jonesboro Anesthesia Inc Past Accepting new patients
Conway Anesthesiology Consultants, P.a. PastSince Mar 1, 2020 Accepting new patients

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1176768000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1245456649",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1006 W CORY ST",
            "city": "OZARK",
            "state": "MO",
            "postal_code": "657216403",
            "telephone_number": "417-581-8720",
            "fax_number": "417-581-8720"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1006 W CORY ST",
            "city": "OZARK",
            "state": "MO",
            "postal_code": "657216403",
            "telephone_number": "417-581-8720",
            "fax_number": "417-581-8720"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLEVENGER",
        "first_name": "DANA",
        "middle_name": "CLAIRE",
        "name_prefix": "Mrs.",
        "credential": "CRNA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-04-17",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MO",
            "license": "101627",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ozark, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.