Debra Jo Bauer Smith, CRNA

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

20039 Issued in SC

Practice address

14 Hawthorne Park CT
Greenville, SC 29615-3194

Phone

(864) 331-0364

Fax

(864) 331-0370

NPI assigned

Jul 17, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Jodi B Johnson Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Registered Nurse

State licenses

Practice roles

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.

• The Health Care Authority of the City of Huntsville

  • Psychiatry Physician
  • Huntsville, AL
  • NPI 1760400535
  NPD (past)

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

{
    "created_epoch": "1153094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1551225600000",
    "number": "1316965874",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "212 BUTLER AVE",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296011913",
            "telephone_number": "256-426-1622"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14 HAWTHORNE PARK CT",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296153194",
            "telephone_number": "864-331-0364",
            "fax_number": "864-331-0370"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "DEBRA",
        "middle_name": "JO BAUER",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-17",
        "last_updated": "2019-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "AL",
            "license": "1-025651",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "SC",
            "license": "20039",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS #",
            "identifier": "51526491",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JODI",
            "last_name": "JOHNSON",
            "middle_name": "B",
            "credential": "CRNA",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Collyn Bowman Smith
• Corey Smith, DO
• Cory Daniel Smith, M.D.
• Courtnie Smith, PSY.D.
• Deborah Smith, OT
• Denise Smith
• Elaine G Smith, MSW LISW CP
• Elizabeth Smith, OTR
• Elizabeth Thorne Smith, NP
• Emma Smith

• Certified Registered Nurse Anesthetist in Greenville, SC
• Providers in Greenville, SC by specialty
• Certified Registered Nurse Anesthetist in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2019; 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.