Individual provider Active NPI

Deanna C. Clinton

  • Certified Registered Nurse Anesthetist
  • Sunrise, FL
National Provider Identifier
1700858107
Registry record updated Mar 4, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
679157 Issued in TX
Practice address
1613 Harrison Pkwy
#200
Sunrise, FL 33323-2853
Phone
(954) 838-2371
NPI assigned
Feb 2, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 4, 2011

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 679157 TX Primary

Addresses

Primary practice location

1613 Harrison Pkwy
#200
Sunrise, FL 33323-2853

Mailing address

PO Box 452319
Sunrise, FL 33345-2319

Other identifiers 4

IdentifierTypeStateIssuer
181072303MedicaidTX
8542UAOtherTXBCBS
181072305MedicaidTX
181012304MedicaidTX

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060905000133 TX Practitioner - Certified Registered Nurse Anesthetist (Crna) 7416951553 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
679157TXMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Endo Sedation LLC Nurse Anesthetist, Certified Registered Current Accepting new patients
University of Texas Southwestern Medical Center at Dallas Current Accepting new patients
Endo Sedation LLC Nurse Anesthetist, Certified Registered CurrentSince Oct 15, 2012 Accepting new patients
Endo Sedation LLC Nurse Anesthetist, Certified Registered CurrentSince Oct 15, 2012 Accepting new patients
University of Texas Southwestern Medical Center at Dallas Nurse Anesthetist, Certified Registered CurrentSince Aug 1, 2022 Accepting new patients
Austin Gastroenterology Anesthesia Associates PLLC Nurse Anesthetist, Certified Registered CurrentSince Aug 1, 2025 Accepting new patients
The University of Texas Southwestern Medical Center at Dallas CurrentSince Aug 1, 2022 Accepting new patients
Northstar Anesthesia, PA Nurse Anesthetist, Certified Registered Past Accepting new patients

Locations

8015 Shoal Creek Blvd
Ste 300
Austin, TX 78757
Phone (512) 371-1519

6201 Harry Hines Blvd
Dallas, TX 75235
Phone (214) 633-4700

5151 Harry Hines Blvd
Dallas, TX 75235
Phone (214) 590-3000

1001 Surrey Ln
Flower Mound, TX 75022
Phone (817) 337-3671

1500 S Main St
Ft Worth, TX 76104
Phone (817) 921-3431

900 8th Ave
Ft Worth, TX 76104
Phone (817) 336-2100

701 Tuscan Dr
Ste 100
Irving, TX 75039
Phone (214) 496-1100

180 Bear Creek Pkwy
Keller, TX 76248
Phone (817) 337-3671

4500 Medical Center Dr
McKinney, TX 75069
Phone (972) 547-8190

515 S Nolen Dr
Southlake, TX 76092
Phone (817) 912-1999

5323 Harry Hines Blvd
Ut Southwest Medical Center, TX 75390

Organizations & group practices 8

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": "1138838400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1299196800000",
    "number": "1700858107",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 452319",
            "city": "SUNRISE",
            "state": "FL",
            "postal_code": "333452319"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1613 HARRISON PKWY",
            "address_2": "#200",
            "city": "SUNRISE",
            "state": "FL",
            "postal_code": "333232853",
            "telephone_number": "954-838-2371"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLINTON",
        "first_name": "DEANNA",
        "middle_name": "C.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-02",
        "last_updated": "2011-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "TX",
            "license": "679157",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "181072303",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "8542UA",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "181072305",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "181012304",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sunrise, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2011; 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.