Active NPI
Shaune Corrinne Southern, CRNA
- Certified Registered Nurse Anesthetist
- Allentown, PA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Certified Registered Nurse Anesthetist
- License
- RN563642
- Practice address
- 1200 S Cedar Crest Blvd
Allentown, PA 18103-6202 - Phone
- (610) 402-8000
- NPI assigned
- Mar 8, 2023
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Anesthesiology Physician | 207L00000X | 147127 | PA | |
| Certified Registered Nurse Anesthetist | 367500000X | RN563642 | PA | Primary |
Addresses
Primary practice location
1200 S Cedar Crest Blvd
Allentown, PA 18103-6202
Mailing address
2763 Township Rd
Riegelsville, PA 18077-9520
Phone (215) 718-4997
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in PA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240213000765 | PA | Practitioner - Certified Registered Nurse Anesthetist (Crna) | 7719320134 | Reassigns benefits to 2 organizations |
Care Compare profile
Medicare Care Compare- Specialty
- Certified Registered Nurse Anesthetist (Crna)
- Education
- Other, 2023
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Lehigh Valley Physician Group
Practice addresses (Care Compare)
330 Main St
Dickson City, PA 18519-1691
Phone (610) 402-6164
Hospital & facility affiliations
- Lehigh Valley Hospital
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 147127 | PA | MD | Anesthesiology Physician |
| RN563642 | PA | MD | Certified Registered Nurse Anesthetist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Lehigh Valley Physician Group | Current | Accepting new patients | |
| Lehigh Valley Physician Group | Current | Accepting new patients | |
| Lehigh Valley Physician Group | Current | Accepting new patients | |
| Lehigh Valley Anesthesia Services, P. C. | Anesthesiology | Current | Accepting new patients |
Locations
2100 Mack Blvd
Allentown, PA 18103
Phone (484) 224-1892
1200 S Cedar Crest Blvd
Allentown, PA 18103
Phone (484) 862-3200
2545 Schoenersville Rd
Bethlehem, PA 18017
Phone (484) 884-2888
5649 Wynnewood Dr
Ste 104
Laurys Station, PA 18059
Phone (610) 262-6641
330 Main St
Scranton, PA 18519
Phone (570) 330-5000
Organizations & group practices 8
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.
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Hospital & facility affiliations 5
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": "1678233600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1707782400000",
"number": "1124728159",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2763 TOWNSHIP RD",
"city": "RIEGELSVILLE",
"state": "PA",
"postal_code": "180779520",
"telephone_number": "215-718-4997"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1200 S CEDAR CREST BLVD",
"city": "ALLENTOWN",
"state": "PA",
"postal_code": "181036202",
"telephone_number": "610-402-8000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SOUTHERN",
"first_name": "SHAUNE",
"middle_name": "CORRINNE",
"credential": "CRNA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-03-08",
"last_updated": "2024-02-13",
"certification_date": "2024-02-13",
"status": "A"
},
"taxonomies": [
{
"code": "207L00000X",
"taxonomy_group": "",
"desc": "Anesthesiology",
"state": "PA",
"license": "147127",
"primary": false
},
{
"code": "367500000X",
"taxonomy_group": "",
"desc": "Nurse Anesthetist, Certified Registered",
"state": "PA",
"license": "RN563642",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Allentown, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 2024; 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.