Individual provider Active NPI

Jenna Dundas Debrabant, CRNA

  • Certified Registered Nurse Anesthetist
  • Cincinnati, OH
National Provider Identifier
1558488114
Registry record updated Apr 20, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
COA.09245-NA Issued in OH
Practice address
4700 Smith Rd
Cincinnati, OH 45212-2787
Phone
(513) 672-3300
Fax
(513) 672-3323
NPI assigned
Mar 26, 2007
Last updated
Apr 20, 2010By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 20, 2010

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 COA.09245-NA OH Primary

Addresses

Primary practice location

4700 Smith Rd
Cincinnati, OH 45212-2787

Mailing address

200 Northland Blvd
1St Floor
Cincinnati, OH 45246-3604
Phone (513) 672-3300

Other identifiers 1

IdentifierTypeStateIssuer
2787884MedicaidOH

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)
Not enrolled
HHS exclusion list flag
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

State licenses

LicenseStateTypeSpecialty
COA.09245-NAOHMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
West Florida Medical Center Clinic PA Past Accepting new patients
Perioperative Medical Consutants Inc Past Accepting new patients
Outpatient Anesthesia Specialists PastSince Jan 1, 2008 Accepting new patients

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1174867200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1271721600000",
    "number": "1558488114",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 NORTHLAND BLVD",
            "address_2": "1ST FLOOR",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452463604",
            "telephone_number": "513-672-3300",
            "fax_number": "513-672-3323"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4700 SMITH RD",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452122787",
            "telephone_number": "513-672-3300",
            "fax_number": "513-672-3323"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEBRABANT",
        "first_name": "JENNA",
        "middle_name": "DUNDAS",
        "name_prefix": "Mrs.",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-26",
        "last_updated": "2010-04-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "OH",
            "license": "COA.09245-NA",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2787884",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cincinnati, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2010; 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.