Shane Tyler Martin, CRNA

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

220519 Issued in AR

Practice address

701 Rahling Rd Apt 2420
Little Rock, AR 72223-5297

Phone

(580) 774-9274

NPI assigned

Mar 7, 2022

Last updated

May 24, 2024By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in AR, MS, TN, OK4 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 4

Specialty

Certified Registered Nurse Anesthetist (Crna)

Education

Other, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

McGowan Court Anesthesia Associates LLCGroup PAC ID 9739330499, 3 clinicians

Youngs Professional Services LLCGroup PAC ID 2163524992, 297 clinicians

Lifelinc Anesthesia V, P.a.Group PAC ID 8921359712, 41 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• CHI St. Vincent Hospital Hot Springs Hospital, Hot Springs, AR, CCN 040026
• Baptist Health - Fort Smith Hospital, Fort Smith, AR, CCN 040055
• Baptist Memorial Hospital Jonesboro, Inc. Hospital, Jonesboro, AR, CCN 040118
• Northwest Medical Center-Springdale Hospital, Springdale, AR, CCN 040022

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Registered Nurse, Nurse Practitioner

Practice roles

Locations (25 of 31)

Interoperability endpoints

• Direct secure messaging: smiller699854@direct.kuha.org

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.

• Lifelinc Anesthesia V, P.a.

  • Anesthesiology Physician
  • West Memphis, AR
  • NPI 1063907244

  Nurse Anesthetist, Certified Registered

  Medicare reassignment Care Compare group NPD
• McGowan Court Anesthesia Associates LLC

  • Certified Registered Nurse Anesthetist
  • Hot Springs, AR
  • NPI 1982955621

  Nurse Anesthetist, Certified Registered

  Medicare reassignment Care Compare group NPD
• Youngs Professional Services LLC

  dba YPS Anesthesia Services

  • Certified Registered Nurse Anesthetist
  • New Iberia, LA
  • NPI 1922178599

  AR, Nurse Anesthetist, Certified Registered

  Medicare reassignment Care Compare group NPD
• Arkansas Health Group

  dba Arkansas Health Group Anesthesia

  • Anesthesiology Physician
  • Little Rock, AR
  • NPI 1508800962
  Medicare reassignment NPD
• Central Arkansas Radiation Therapy Institute Inc

  • Hematology & Oncology Physician
  • Little Rock, AR
  • NPI 1508147810
  Medicare reassignment NPD
• Dream Team Anesthesia, LLC

  • Certified Registered Nurse Anesthetist
  • Little Rock, AR
  • NPI 1215629464

  Nurse Anesthetist, Certified Registered

  Medicare reassignment NPD
• Johnson Regional Medical Center

  dba JRMC Anesthesia

  • Anesthesiology Physician
  • Clarksville, AR
  • NPI 1396794525
  Medicare reassignment NPD
• Southern Regional Anesthesiology Consultants PLLC

  • Anesthesiology Physician
  • Little Rock, AR
  • NPI 1902231673
  Medicare reassignment NPD
• St. Vincent Medical Group

  • Family Medicine Physician
  • Little Rock, AR
  • NPI 1134176480
  Medicare reassignment NPD
• University of Arkansas for Medical Sciences

  dba Childrens University Medical Group

  • Pediatrics Physician
  • Little Rock, AR
  • NPI 1346230968
  Medicare reassignment NPD
• University of Arkansas for Medical Sciences

  • Internal Medicine Physician
  • Little Rock, AR
  • NPI 1588654016
  Medicare reassignment NPD
• American Anesthesiology of Tennessee, P.C.

  • Anesthesiology Physician
  • Knoxville, TN
  • NPI 1609822998
  Medicare reassignment NPD

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

• Baptist Health Regional Hospitals

  dba Baptist Health - Fort Smith

  • General Acute Care Hospital
  • Fort Smith, AR
  • NPI 1710463146
  Care Compare affiliation
• Baptist Memorial Hospital-Jonesboro Inc

  dba NEA Baptist Memorial Hospital

  • General Acute Care Hospital
  • Jonesboro, AR
  • NPI 1386699353
  Care Compare affiliation
• CHI St Vincent Hospital Hot Springs

  • Home Delivered Meals
  • Hot Springs, AR
  • NPI 1033157375

  Hospital

  Care Compare affiliation
• CHI St Vincent Hospital Hot Springs

  • General Acute Care Hospital
  • Hot Springs, AR
  • NPI 1316144546
  Care Compare affiliation
• CHI St Vincent Hospital Hot Springs

  • General Practice Physician
  • Hot Springs, AR
  • NPI 1497880124

  Hospital

  Care Compare affiliation
• CHI St Vincent Hospital Hot Springs

  • Psychiatric Hospital Unit
  • Hot Springs, AR
  • NPI 1619915949
  Care Compare affiliation
• CHI St Vincent Hospital Hot Springs

  • General Acute Care Hospital
  • Hot Springs, AR
  • NPI 1689628232
  Care Compare affiliation
• Mercy Hospital Hot Springs

  • Clinic/Center
  • Hot Springs, AR
  • NPI 1174705388

  Hospital

  Care Compare affiliation
• Northwest Arkansas Hospitals, LLC

  dba Northwest Medical Center

  • General Acute Care Hospital
  • Springdale, AR
  • NPI 1699726695
  Care Compare affiliation

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

{
    "created_epoch": "1646611200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716508800000",
    "number": "1083361257",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "701 RAHLING RD APT 2420",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722235297",
            "telephone_number": "580-774-9274"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "701 RAHLING RD APT 2420",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722235297",
            "telephone_number": "580-774-9274"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "801 Cottage Dr",
            "address_purpose": "LOCATION",
            "city": "Little Rock",
            "state": "AR",
            "postal_code": "722055400",
            "country_code": "US",
            "telephone_number": "501-686-8818",
            "fax_number": "501-526-7217",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "SHANE",
        "middle_name": "TYLER",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-03-07",
        "last_updated": "2024-05-24",
        "certification_date": "2024-05-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "AR",
            "license": "220519",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Renita Kaye Martin, APRN
• Robert Martin, M.D.
• Robert Marc Martin
• Ronald Jay Martin, M.D.
• Roxie Martin, QBHP
• Terri Lynn Martin, MD
• Traci Martin
• Tykeisha Sade Martin
• Wendell Martin
• Xavier Martin

• Certified Registered Nurse Anesthetist in Little Rock, AR
• Providers in Little Rock, AR by specialty
• Certified Registered Nurse Anesthetist in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 24, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.