Individual provider Active NPI

Cheryl A Clabough, CRNA

  • Certified Registered Nurse Anesthetist
  • Birmingham, AL
National Provider Identifier
1972583979
Registry record updated Mar 3, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
1101428 Issued in AL
Practice address
2720 University Blvd
Birmingham, AL 35233-3408
Phone
(205) 989-1080
Fax
(205) 989-1087
NPI assigned
Jan 18, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 3, 2014

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 1101428 AL Primary

Addresses

Primary practice location

2720 University Blvd
Birmingham, AL 35233-3408

Mailing address

2151 Old Rocky Ridge Rd
Suite 106
Birmingham, AL 35216-7235
Phone (205) 989-1080

Other identifiers 4

IdentifierTypeStateIssuer
P00424062OtherALMEDICARE RAILROAD
009912716MedicaidAL
194586799OtherALTRICARE
515-42275OtherALBLUECROSS BLUESHIELD

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040604000845 AL Practitioner - Certified Registered Nurse Anesthetist (Crna) 4385558279 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1101428ALMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Blue Lake Health Alabama, LLC CurrentSince Jun 1, 2023 Accepting new patients
Anesthesiology Services Network LTD Past Accepting new patients
Anesthesiology Consultants of Toledo, Inc Past Accepting new patients
Lima Memorial Joint Operating Company Past Accepting new patients

Locations

2720 University Blvd
Birmingham, AL 35233
Phone (205) 581-5380

103 Helton Ct
Florence, AL 35630
Phone (256) 389-8228

Organizations & group practices 4

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": "1137542400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1393804800000",
    "number": "1972583979",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2151 OLD ROCKY RIDGE RD",
            "address_2": "SUITE 106",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352167235",
            "telephone_number": "205-989-1080",
            "fax_number": "205-989-1087"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2720 UNIVERSITY BLVD",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352333408",
            "telephone_number": "205-989-1080",
            "fax_number": "205-989-1087"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLABOUGH",
        "first_name": "CHERYL",
        "middle_name": "A",
        "name_prefix": "Mrs.",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-01-18",
        "last_updated": "2014-03-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "AL",
            "license": "1101428",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "P00424062",
            "state": "AL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "009912716",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE",
            "identifier": "194586799",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUECROSS BLUESHIELD",
            "identifier": "515-42275",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Birmingham, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 2014; 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.