CMS-1500 Box 24J / 33a • NPI
1487814133
Type 1 Individual Rendering/Ordering
HIPAA NUCC Taxonomy • CMS Code
367500000X (CMS 43)
Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers — Nurse Anesthetist, Certified Registered
Box 32 Service Location & ZIP+4
1755 KIRBY PKWY, SUITE 330, MEMPHIS, TN, 38120
Official NPPES Practice Location
✓ HHS OIG LEIE Sanction Screening — VERIFIED CLEAR:
NPI
1487814133 (MARY BOERS, CRNA) has 0 active federal exclusions across all 84,224 HHS OIG LEIE sanction records (Database Verified: 2026-11-11).
CMS Medicare Order & Referring PECOS Eligibility
Medicare Part B
✓ Eligible
DMEPOS Ordering
No
Home Health (HHA)
No
Power Mobility
No
Hospice Referring
No
Official CMS NPPES Credential & Practice Profile
| 10-Digit NPI Number | 1487814133 (NPI-1 Individual Practitioner) |
|---|---|
| Provider / Legal Name | MARY BOERS, CRNA |
| Plain-English Specialty | Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers — Nurse Anesthetist, Certified Registered NUCC Code: 367500000X (Nurse Anesthetist, Certified Registered) |
| Certifying / Licensing Body | State Medical / Healthcare Licensing Board & National Specialty Board |
| Practice Location Address | 1755 KIRBY PKWY, SUITE 330, MEMPHIS, TN, 38120 |
| Practice Telephone / Fax | Tel: (901) 725-5846 | Fax: (901) 726-4827 |
| Administrative Mailing Address | PO BOX 171306, MEMPHIS, TN, 38187-1306 |
| Enumeration & Last Sync | Enumerated: 2008-06-16 | CMS Record Updated: 2026-10-05 |
Clinic Location, Accessibility & Directions
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Plain-English Taxonomy & CMS Crosswalk (367500000X)
What Does Taxonomy Code 367500000X Mean?
In the HIPAA National Uniform Claim Committee (NUCC) classification, code 367500000X translates to:
"Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers — Nurse Anesthetist, Certified Registered"
Specialty Clinical Procedures & Therapeutic Classes
Standard Scope of Care (MARY BOERS, CRNA)
Typical CPT / Diagnostic Procedures:- Comprehensive Outpatient & Inpatient Clinical Evaluation (CPT 99202–99215)
- Diagnostic Workup, Laboratory Ordering & Evidence-Based Care Coordination
- Preventive Screening, Patient Counseling & Multidisciplinary Referral
- Evidence-Based Specialty Pharmacotherapy & Preventive Regimens (CMS Part D Standard)
All Registered NUCC Taxonomies & State Licenses
| Taxonomy Code & Plain-English Description | State License & Primary Status |
|---|---|
367500000X — Nurse Anesthetist, Certified RegisteredPlain English: Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers — Nurse Anesthetist, Certified Registered | State: KS | License: 43-558354 | Primary: Secondary |
367500000X — Nurse Anesthetist, Certified RegisteredPlain English: Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers — Nurse Anesthetist, Certified Registered | State: TN | License: 112814 | Primary: Yes (Primary) |
Medical Billing, RCM & Hospital Credentialing Teams:
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