NPIMap

Organization Active NPI

Shelby Anesthesiology Associates PA

  • Anesthesiology Physician
  • Shelby, NC
National Provider Identifier
1023069291
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
Legal business name
SHELBY ANESTHESIOLOGY ASSOCIATES PA
Practice address
201 E Grover St
Shelby, NC 28150-3917
Phone
(704) 487-3000
Fax
(706) 737-2272
NPI assigned
May 13, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Authorized official

Name
Dr. Wilson Farris Surratt, MDNPI 1053366138
Title
President
Phone
(704) 482-5716

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207L00000X NC Primary
Pain Medicine (Anesthesiology) PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207LP2900X NC
Certified Registered Nurse AnesthetistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 367500000X NC

Addresses

Primary practice location

201 E Grover St
Shelby, NC 28150-3917

Mailing address

PO Box 890561
Charlotte, NC 28289-0561
Phone (800) 919-1190

Other identifiers 2

IdentifierTypeStateIssuer
7901418MedicaidNC
01418OtherNCBLUE CROSS

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 10

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1147478400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1023069291",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 890561",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282890561",
            "telephone_number": "800-919-1190",
            "fax_number": "706-737-2272"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 E GROVER ST",
            "city": "SHELBY",
            "state": "NC",
            "postal_code": "281503917",
            "telephone_number": "704-487-3000",
            "fax_number": "706-737-2272"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHELBY ANESTHESIOLOGY ASSOCIATES PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-13",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "SURRATT",
        "authorized_official_first_name": "WILSON",
        "authorized_official_middle_name": "FARRIS",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "704-482-5716",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Anesthesiology",
            "state": "NC",
            "license": null,
            "primary": true
        },
        {
            "code": "207LP2900X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "NC",
            "license": null,
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "NC",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7901418",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "01418",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Shelby, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.