Individual provider Active NPI

Debran Lynn Harmon-O'Connor, MSN, CRNA, ARNP

  • Certified Registered Nurse Anesthetist
  • Jacksonville, FL
National Provider Identifier
1669494498
Registry record updated Aug 13, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
2804752 Issued in FL
Practice address
2165 Herschel St
Jacksonville, FL 32204-3819
Phone
(904) 387-4030
Fax
(904) 381-9808
NPI assigned
Jul 24, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 13, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 2804752 FL
Certified Registered Nurse Anesthetist 367500000X 2804752 FL Primary

Addresses

Primary practice location

2165 Herschel St
Jacksonville, FL 32204-3819

Mailing address

MSC#662 PO Box 830529
Birmingham, AL 35283-0529
Phone (844) 211-1592

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070411000146 FL Practitioner - Certified Registered Nurse Anesthetist (Crna) 2365547940 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Jacksonville Beaches Anesthesia Associates, Inc.Group PAC ID 1759458540, 15 clinicians

Practice addresses (Care Compare)

3316 3Rd S St
Suite 200
Jacksonville Beach, FL 32250-6091
Phone (904) 247-8181

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse, Master of Science - Nursing

State licenses

LicenseStateTypeSpecialty
2804752FLMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Jacksonville Beaches Anesthesia Associates, Inc. Nurse Anesthetist, Certified Registered CurrentSince May 21, 2018 Accepting new patients

Locations

3316 3rd St S
Ste 200
Jax Bch, FL 32250
Phone (904) 247-8181

Organizations & group practices 1

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": "1153699200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1439424000000",
    "number": "1669494498",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "MSC#662 PO BOX 830529",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352830529",
            "telephone_number": "844-211-1592"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2165 HERSCHEL ST",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322043819",
            "telephone_number": "904-387-4030",
            "fax_number": "904-381-9808"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARMON-O'CONNOR",
        "first_name": "DEBRAN",
        "middle_name": "LYNN",
        "name_prefix": "Mrs.",
        "credential": "MSN, CRNA, ARNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-24",
        "last_updated": "2015-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "FL",
            "license": "2804752",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "FL",
            "license": "2804752",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2015; 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.