Individual provider Active NPI

Antonni Lashae Shingles

  • Certified Registered Nurse Anesthetist
  • Cordova, TN
National Provider Identifier
1003143843
Registry record updated Jul 11, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
14807 Issued in TN
Practice address
1360 Beaver Trail Dr
Cordova, TN 38016-9601
Phone
(901) 754-2927
NPI assigned
Nov 16, 2009
Last updated
Jul 11, 2011By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 11, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X RN 149251 TN
Certified Registered Nurse Anesthetist 367500000X 14807 TN Primary

Addresses

Primary practice location

1360 Beaver Trail Dr
Cordova, TN 38016-9601

Mailing address

1360 Beaver Trail Dr
Cordova, TN 38016-9601

Other identifiers 4

IdentifierTypeStateIssuer
4252851OtherTNBLUE CROSS OF TN
1003143843OtherCHAMPUS/TRICARE
187026001OtherARARKANSAS MEDICAID
1519463MedicaidTN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN, MS2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20100611000149 TN Practitioner - Certified Registered Nurse Anesthetist (Crna) 8325178742 Reassigns benefits to 2 organizations
I20160804001294 MS Practitioner - Certified Registered Nurse Anesthetist (Crna) 8325178742 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
University of Tennessee, HSC, College of Medicine, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Resource Anesthesiology Associates of TN PCGroup PAC ID 8527419092, 145 clinicians

Practice addresses (Care Compare)

1265 Union Ave
Suite 201
Memphis, TN 38104-3415
Phone (901) 516-7000

4250 Bethel Rd
Olive Branch, MS 38654-8737
Phone (662) 932-9000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
85.75 of 100Reported as group
Quality
83.24
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RN 149251TNMDRegistered Nurse
14807TNMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Resource Anesthesiology Associates of TN PC Nurse Anesthetist, Certified Registered CurrentSince Feb 9, 2024 Accepting new patients
Medical Anesthesia Group, PA CurrentSince Nov 1, 2015 Accepting new patients

Locations

4250 Bethel Rd
Olive Branch, MS 38654
Phone (662) 932-9000

7580 Clarington Cv
Southaven, MS 38671
Phone (901) 259-1600

450 Mamaroneck Ave
Ste 201
Harrison, NY 10528
Phone (877) 476-6642

1265 Union Ave
Memphis, TN 38104
Phone (901) 516-2362

1265 Union Ave
Ste 201
Memphis, TN 38104
Phone (901) 516-7000

1300 Wesley Dr
Memphis, TN 38116
Phone (901) 516-3700

3960 New Covington Pike
Memphis, TN 38128
Phone (901) 516-5200

6060 E Primacy Pkwy
Ste 241
Memphis, TN 38119
Phone (901) 725-5846

7691 Poplar Ave
Memphis, TN 38138
Phone (901) 516-1290

Organizations & group practices 2

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1258329600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1310342400000",
    "number": "1003143843",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1360 BEAVER TRAIL DR",
            "city": "CORDOVA",
            "state": "TN",
            "postal_code": "380169601"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1360 BEAVER TRAIL DR",
            "city": "CORDOVA",
            "state": "TN",
            "postal_code": "380169601",
            "telephone_number": "901-754-2927"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHINGLES",
        "first_name": "ANTONNI",
        "middle_name": "LASHAE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-11-16",
        "last_updated": "2011-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "TN",
            "license": "RN 149251",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "TN",
            "license": "14807",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS OF TN",
            "identifier": "4252851",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CHAMPUS/TRICARE",
            "identifier": "1003143843",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ARKANSAS MEDICAID",
            "identifier": "187026001",
            "state": "AR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1519463",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cordova, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 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.