Individual provider Active NPI

Debra A Clair, PHD CNS

  • Clinical Nurse Specialist
  • Alliance, OH
National Provider Identifier
1689639452
Registry record updated Jul 26, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Nurse SpecialistTaxonomy code 364S00000X
License
NS04225 Issued in OH
Practice address
200 E State St
Wound Care
Alliance, OH 44601-4936
Phone
(330) 596-7940
NPI assigned
Apr 17, 2006
Last updated
Jul 26, 2012By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 26, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Nurse Specialist 364S00000X NS04225 OH Primary

Addresses

Primary practice location

200 E State St
Wound Care
Alliance, OH 44601-4936

Mailing address

200 E State St
Wound Care
Alliance, OH 44601-4936
Phone (330) 596-7940

Other identifiers 1

IdentifierTypeStateIssuer
2459450MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040601000289 OH Practitioner - Certified Clinical Nurse Specialist (CNS) 6204817646 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Specialist, Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
NS04225OHMDClinical Nurse Specialist

Practice roles

OrganizationSpecialtyStatusNew patients
Robinson Health System, Inc. CurrentSince Jul 13, 2014 Accepting new patients
Galaxy Medical Products, LLC Past Accepting new patients
Alliance Community Medical Foundation LLC Past Accepting new patients

Locations

6847 N Chestnut St
Ravenna, OH 44266
Phone (330) 296-9606

6847 N Chestnut St
Ste 325
Ravenna, OH 44266
Phone (330) 296-2819

Interoperability endpoints

  • Direct secure messaging: dclair27994@ehrdirect.uhhospitals.org

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": "1145232000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1343260800000",
    "number": "1689639452",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 E STATE ST",
            "address_2": "WOUND CARE",
            "city": "ALLIANCE",
            "state": "OH",
            "postal_code": "446014936",
            "telephone_number": "330-596-7940"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 E STATE ST",
            "address_2": "WOUND CARE",
            "city": "ALLIANCE",
            "state": "OH",
            "postal_code": "446014936",
            "telephone_number": "330-596-7940"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLAIR",
        "first_name": "DEBRA",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "PHD CNS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-17",
        "last_updated": "2012-07-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "364S00000X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist",
            "state": "OH",
            "license": "NS04225",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2459450",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Alliance, OH

Sources for this page

Verify at the official NPI Registry.