Shannon Lynn Kopecky, CRNA

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

4998 Issued in NC

Practice address

2650 Ridge Ave
Anesthesiology, Room 3905
Evanston, IL 60201-1718

Phone

(847) 570-2760

Fax

(847) 570-2921

NPI assigned

Mar 15, 2007

Last updated

Jan 11, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in NC

Enrollment records 1

Specialty

Certified Registered Nurse Anesthetist (Crna)

Education

Other, 2006

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

The Presbyterian HospitalGroup PAC ID 1153231907, 412 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Novant Health Huntersville Medical Center Hospital, Huntersville, NC, CCN 340183

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Registered Nurse

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: skopecky162253@direct.novanthealth.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.

• The Presbyterian Hospital

  dba Novant Health Senior Care

  • Geriatric Medicine (Internal Medicine) Physician
  • Charlotte, NC
  • NPI 1053365817
  Medicare reassignment Care Compare group NPD
• Brunswick Community Hospital, LLC

  dba Novant Health Brunswick Medical Center CRNAS

  • Certified Registered Nurse Anesthetist
  • Bolivia, NC
  • NPI 1669725198

  Nurse Anesthetist, Certified Registered

  Medicare reassignment NPD
• Forsyth Memorial Hospital, Inc.

  dba NH Forsyth Primary Care Clinics

  • Family Medicine Physician
  • Winston Salem, NC
  • NPI 1104548874
  Medicare reassignment NPD
• Medical Park Hospital LLC

  dba Medical Park Professional Fee

  • Specialist
  • Winston Salem, NC
  • NPI 1003867516
  Medicare reassignment NPD
• Novant Health Ballantyne Medical Center LLC

  • Certified Registered Nurse Anesthetist
  • Charlotte, NC
  • NPI 1760190607

  Nurse Anesthetist, Certified Registered

  Medicare reassignment NPD
• Novant Health Clemmons Outpatient Surgery, LLC

  • Ambulatory Surgical Clinic/Center
  • Clemmons, NC
  • NPI 1528521887
  Medicare reassignment NPD
• Novant Health Kernersville Outpatient Surgery LLC

  • Ambulatory Surgical Clinic/Center
  • Kernersville, NC
  • NPI 1750892659
  Medicare reassignment NPD
• Novant Health Matthews Medical Center LLC

  dba Professional Services of Presbyterian Matthews

  • Specialist
  • Matthews, NC
  • NPI 1184782419
  Medicare reassignment NPD
• Novant Health Mint Hill Medical Center, LLC

  dba Professional Fees

  • Certified Registered Nurse Anesthetist
  • Charlotte, NC
  • NPI 1063910404

  Nurse Anesthetist, Certified Registered

  Medicare reassignment NPD
• Novant Health Rowan Medical Center LLC

  • Neurology Physician
  • Salisbury, NC
  • NPI 1508931544

  Nurse Anesthetist, Certified Registered

  Medicare reassignment NPD
• Novant Health Thomasville Medical Center, LLC

  dba Professional Service of Thomasville Medical Center

  • Specialist
  • Thomasville, NC
  • NPI 1033160205

  Nurse Anesthetist, Certified Registered

  Medicare reassignment NPD
• Presbyterian Sameday Surgery Center at Ballantyne LLC

  dba Novant Health Ballantyne Outpatient Surgery

  • Ambulatory Surgical Clinic/Center
  • Charlotte, NC
  • NPI 1215061049
  Medicare reassignment NPD

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

• The Presbyterian Hospital

  dba Novant Health Huntersville Medical Center

  • General Acute Care Hospital
  • Huntersville, NC
  • NPI 1346291309
  Care Compare affiliation

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

{
    "created_epoch": "1173916800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704931200000",
    "number": "1154455962",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2650 RIDGE AVE",
            "address_2": "EVANSTON HOSPITAL",
            "city": "EVANSTON",
            "state": "IL",
            "postal_code": "602011718",
            "telephone_number": "847-570-1206",
            "fax_number": "847-570-1248"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2650 RIDGE AVE",
            "address_2": "ANESTHESIOLOGY, ROOM 3905",
            "city": "EVANSTON",
            "state": "IL",
            "postal_code": "602011718",
            "telephone_number": "847-570-2760",
            "fax_number": "847-570-2921"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOPECKY",
        "first_name": "SHANNON",
        "middle_name": "LYNN",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-15",
        "last_updated": "2024-01-11",
        "certification_date": "2024-01-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "IL",
            "license": "041-318243",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "NC",
            "license": "75953",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "NC",
            "license": "4998",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "IL STATE LIC",
            "identifier": "041-318243",
            "state": "IL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "SKOPECKY162253@DIRECT.NOVANTHEALTH.ORG",
            "affiliation": "N",
            "address_1": "2650 Ridge Ave",
            "address_2": "Anesthesiology, Room 3905",
            "city": "Evanston",
            "state": "IL",
            "country_code": "US",
            "postal_code": "602011718",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Ella Komarovsky, M.D.
• Madhuri V Konanahalli, M.D.
• Athanasios Kondilis, DO/PHD
• Dalia Esmeralda Koo
• Wendy Kopald, LCSW
• Theresa Marie Kopitzke, LCPC
• Katherine Anne Kopkash, M.D.
• Joseph Victor Kopke, PT, DPT
• Hana D. Koppel, PA-C
• Carly Kopplin, PT, DPT

• Certified Registered Nurse Anesthetist in Evanston, IL
• Providers in Evanston, IL by specialty
• Certified Registered Nurse Anesthetist in Illinois

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

Verify at the official NPI Registry.