Rebecca B Mauck, CRNA

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

CRNA0645 Issued in AZ

Practice address

6308 8TH Ave
Kenosha, WI 53143

Phone

(262) 656-2011

NPI assigned

Mar 17, 2009

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in AZ

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Registered Nurse

State licenses

Practice roles

Locations

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.

• Grand Canyon Anesthesia LLC

  • Anesthesiology Physician
  • Scottsdale, AZ
  • NPI 1356822902

  Nurse Anesthetist, Certified Registered

  Medicare reassignment NPD
• Scottsdale Surgical Partners LLC

  dba North Scottsdale Anesthesia

  • Anesthesiology Physician
  • Scottsdale, AZ
  • NPI 1396232559
  Medicare reassignment NPD
• Cigna Health Care of Arizona Inc.

  dba CMG Clyde Wright Urgent Care, CMG Clyde Wright AHC, Phoenix Central UC

  • Urgent Care Clinic/Center
  • Phoenix, AZ
  • NPI 1245338235
  NPD
• Cigna Health Care of Arizona Inc.

  dba Clyde Wright Center, CMG Phx Central MultiSpec Cntr

  • Multi-Specialty Clinic/Center
  • Phoenix, AZ
  • NPI 1942371679
  NPD
• Midwest Physicians Anesthesia Service, SC

  • Pain Medicine (Anesthesiology) Physician
  • Kenosha, WI
  • NPI 1275586653
  NPD (past)

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

{
    "created_epoch": "1237248000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1536192000000",
    "number": "1629219944",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 7096",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952670096",
            "telephone_number": "209-956-7725"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6308 8TH AVE",
            "city": "KENOSHA",
            "state": "WI",
            "postal_code": "53143",
            "telephone_number": "262-656-2011"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8901 E Raintree Dr Ste 100",
            "address_purpose": "LOCATION",
            "city": "Scottsdale",
            "state": "AZ",
            "postal_code": "85260",
            "country_code": "US",
            "telephone_number": "480-767-2100",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MAUCK",
        "first_name": "REBECCA",
        "middle_name": "B",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-03-17",
        "last_updated": "2018-09-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "WI",
            "license": "165541",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "AZ",
            "license": "RN160242",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "AZ",
            "license": "CRNA0645",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Harry M Matschke, M.D.
• John C Matteucci Jr., M.D.
• Michelle M Matthews, LCSW
• Andrea M Mattison, PAC
• Suzanne P Mattox, MD
• Trista Anne Maulson, M.S.
• Kelly Mauser, PTA
• Mayer Drug Inc (Larsen Mayer Pharmacy)
• Nicholas R Mayor, MA LPC SAC
• Krystal Mazzulla, RN

• Certified Registered Nurse Anesthetist in Kenosha, WI
• Providers in Kenosha, WI by specialty
• Certified Registered Nurse Anesthetist in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.