Individual provider Active NPI

Mary Virginia Clare, CRNA

  • Certified Registered Nurse Anesthetist
  • Girard, GA
National Provider Identifier
1730472127
Registry record updated May 18, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
RN118261 Issued in GA
Practice address
2786 Stony Bluff Rd
Girard, GA 30426-3733
Phone
(912) 829-3510
Fax
(912) 829-3510
NPI assigned
May 18, 2011
Last updated
May 18, 2011By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 18, 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 RN118261 GA Primary

Addresses

Primary practice location

2786 Stony Bluff Rd
Girard, GA 30426-3733

Mailing address

2786 Stony Bluff Rd
Girard, GA 30426-3733
Phone (912) 829-3510

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120508000700 GA Practitioner - Certified Registered Nurse Anesthetist (Crna) 8022270065 Reassigns benefits to 7 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Medical College of Georgia School of Medicine, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sleep EzzyGroup PAC ID 4486920295, 23 clinicians

Practice addresses (Care Compare)

455 Philip Blvd
Suite 138
Lawrenceville, GA 30046-8768
Phone (770) 962-3642

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
RN118261GAMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Sleep Ezzy CurrentSince Feb 26, 2024 Accepting new patients
Gi Anesthesia of Georgia LLC Nurse Anesthetist, Certified Registered CurrentSince Jul 1, 2022 Accepting new patients
Ams Southeast LLC Nurse Anesthetist, Certified Registered CurrentSince Apr 26, 2018 Accepting new patients
Anesthesia of Coastal Georgia LLC Nurse Anesthetist, Certified Registered CurrentSince Dec 11, 2011 Accepting new patients
American Anesthesiology Associates of Georgia, LLC CurrentSince Feb 1, 2018 Accepting new patients
Coastal Ambulatory Anesthesia LLC CurrentSince May 19, 2022 Accepting new patients
Au Anesthesiology LLC Nurse Anesthetist, Certified Registered CurrentSince Nov 1, 2023 Accepting new patients
Statesboro Hma Physician Management LLC Nurse Anesthetist, Certified Registered Past Accepting new patients

Locations

7956 Vaughn Rd
Ste 165
Montgomery, AL 36116

6094 14th St W
Ste 122
Bradenton, FL 34207

2260 Wrightsboro Rd
Augusta, GA 30904
Phone (706) 481-7000

3303 Glynn Ave
Brunswick, GA 31520
Phone (912) 354-4800

2701 N Decatur Rd
Decatur, GA 30033
Phone (404) 501-1000

1955 Textile Way
Gainesville, GA 30501
Phone (678) 987-1499

455 Philip Blvd
Ste 138
Lawrenceville, GA 30046

892 Legacy Park Dr
Lawrenceville, GA 30043

1139 Lexington Ave
Savannah, GA 31404
Phone (912) 303-4200

519 Stephenson Ave
Savannah, GA 31405

5353 Reynolds St
Savannah, GA 31405
Phone (912) 692-6172

728 E 67th St
Savannah, GA 31405
Phone (912) 352-3120

1499 Fair Rd
Statesboro, GA 30458
Phone (912) 486-1000

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, 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": "1305676800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1305676800000",
    "number": "1730472127",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2786 STONY BLUFF RD",
            "city": "GIRARD",
            "state": "GA",
            "postal_code": "304263733",
            "telephone_number": "912-829-3510",
            "fax_number": "912-829-3510"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2786 STONY BLUFF RD",
            "city": "GIRARD",
            "state": "GA",
            "postal_code": "304263733",
            "telephone_number": "912-829-3510",
            "fax_number": "912-829-3510"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARE",
        "first_name": "MARY",
        "middle_name": "VIRGINIA",
        "name_prefix": "Mrs.",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-05-18",
        "last_updated": "2011-05-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "GA",
            "license": "RN118261",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Girard, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 18, 2011; 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.