Individual provider Active NPI

Lea Ellen Welborn, CRNA

  • Certified Registered Nurse Anesthetist
  • Oxford, MS
National Provider Identifier
1487684767
Registry record updated Sep 19, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
R861834 Issued in MS
Practice address
1208 Office Park Dr
Oxford, MS 38655-3597
Phone
(662) 234-9888
Fax
(662) 281-8927
NPI assigned
Jul 3, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 19, 2022

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 R861834 MS Primary

Addresses

Primary practice location

1208 Office Park Dr
Oxford, MS 38655-3597

Mailing address

2020 Exeter Rd
Germantown, TN 38138-3945

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080512000695 MS Practitioner - Certified Registered Nurse Anesthetist (Crna) 0244259752 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Oxford Anesthesia GroupGroup PAC ID 2668801218, 2 clinicians

Practice addresses (Care Compare)

497 Azalea Dr
Suite 101
Oxford, MS 38655-7907
Phone (662) 234-1337

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
R861834MSMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Willow Anesthesia Services LLC Nurse Anesthetist, Certified Registered CurrentSince Jun 1, 2013 Accepting new patients
Oxford Anesthesia Group Nurse Anesthetist, Certified Registered CurrentSince Mar 20, 2020 Accepting new patients
Anesthesia Services of Decatur PC Past Accepting new patients
Northstar Anesthesia of Alabama, LLC Past Accepting new patients

Locations

960 Avent Dr
Grenada, MS 38901
Phone (662) 227-7000

497 Azalea Dr
Ste 101
Oxford, MS 38655
Phone (662) 234-1337

Organizations & group practices 4

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": "1151884800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663545600000",
    "number": "1487684767",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2020 EXETER RD",
            "city": "GERMANTOWN",
            "state": "TN",
            "postal_code": "381383945"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1208 OFFICE PARK DR",
            "city": "OXFORD",
            "state": "MS",
            "postal_code": "386553597",
            "telephone_number": "662-234-9888",
            "fax_number": "662-281-8927"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WELBORN",
        "first_name": "LEA",
        "middle_name": "ELLEN",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-03",
        "last_updated": "2022-09-19",
        "certification_date": "2022-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MS",
            "license": "R861834",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oxford, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2022; 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.