Individual provider Active NPI

Shelly Harley, CRNA

  • Certified Registered Nurse Anesthetist
  • Orange, TX
National Provider Identifier
1053449488
Registry record updated Apr 21, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
537368 Issued in TX
Practice address
608 Strickland Dr
Dept. of Anesthesia
Orange, TX 77630-4717
Phone
(409) 883-1303
NPI assigned
Feb 28, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 21, 2016

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 537368 TX Primary

Addresses

Primary practice location

608 Strickland Dr
Dept. of Anesthesia
Orange, TX 77630-4717

Mailing address

PO Box 2127
Dept. of Anesthesia
Athens, TX 75751-7127
Phone (903) 677-1000

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050817000900 TX Practitioner - Certified Registered Nurse Anesthetist (Crna) 6305876533 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Emergenchealth PLLCGroup PAC ID 1355606641, 1,037 clinicians

Practice addresses (Care Compare)

224 E 2ND St
Moore County Hosp Dist
Dumas, TX 79029-3808
Phone (806) 934-7824

Hospital & facility affiliations

  • Ut Health East Texas Jacksonville Hospital Hospital, Jacksonville, TX, CCN 450194

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
537368TXMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Emergenchealth PLLC Nurse Anesthetist, Certified Registered CurrentSince Jun 15, 2021 Accepting new patients
Palo Pinto County Hospital District Current Accepting new patients
Palo Pinto County Hospital District Current Accepting new patients
Palo Pinto County Hospital District Nurse Anesthetist, Certified Registered CurrentSince Sep 4, 2018 Accepting new patients
Palo Pinto County Hospital District CurrentSince Sep 4, 2018 Accepting new patients
Central Kansas Anesthesia PA Nurse Anesthetist, Certified Registered Past Accepting new patients

Locations

224 E 2nd St
Dumas, TX 79029
Phone (806) 934-7813

501 S Ragsdale St
Jacksonville, TX 75766
Phone (903) 541-5000

400 SW 25th Ave
Mineral Wells, TX 76067
Phone (940) 325-7891

7400 Barlite Blvd
San Antonio, TX 78224
Phone (210) 921-2000

Organizations & group practices 6

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.

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": "1172620800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1461196800000",
    "number": "1053449488",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2127",
            "address_2": "DEPT. OF ANESTHESIA",
            "city": "ATHENS",
            "state": "TX",
            "postal_code": "757517127",
            "telephone_number": "903-677-1000",
            "fax_number": "903-677-1694"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "608 STRICKLAND DR",
            "address_2": "DEPT. OF ANESTHESIA",
            "city": "ORANGE",
            "state": "TX",
            "postal_code": "776304717",
            "telephone_number": "409-883-1303"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARLEY",
        "first_name": "SHELLY",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-28",
        "last_updated": "2016-04-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "TX",
            "license": "537368",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orange, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 2016; 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.