Shane D Faltys, CRNA

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

2004031200 Issued in MO

Practice address

2620 N Westwood Blvd
Poplar Bluff, MO 63901-3396

Phone

(573) 718-2710

NPI assigned

Apr 24, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in IA

Enrollment records 1

Specialty

Certified Registered Nurse Anesthetist (Crna)

Education

Other, 2002

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Unitypoint Health - MarshalltownGroup PAC ID 0941587307, 24 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Unitypoint Health - Marshalltown Hospital, Marshalltown, IA, CCN 160001

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Registered Nurse

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: sfaltys636486@direct.unitypoint.org

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.

• Unitypoint Health - Marshalltown

  • Emergency Medicine Physician
  • Marshalltown, IA
  • NPI 1164957593

  Nurse Anesthetist, Certified Registered

  Medicare reassignment Care Compare group NPD
• Waverly Health Center

  • Certified Registered Nurse Anesthetist
  • Waverly, IA
  • NPI 1033125463

  Nurse Anesthetist, Certified Registered

  Medicare reassignment NPD
• Salahuddin Syed MD PC

  • Anatomic Pathology & Clinical Pathology Physician
  • Marshalltown, IA
  • NPI 1083054464
  NPD
• St Luke'S Methodist Hospital

  • General Acute Care Hospital
  • Cedar Rapids, IA
  • NPI 1083708226
  NPD
• Unitypoint Health - Marshalltown

  • Rural Health Clinic/Center
  • Waverly, IA
  • NPI 1124655006
  NPD
• Waverly Health Center

  • Rural Health Clinic/Center
  • Janesville, IA
  • NPI 1184094534
  NPD
• Poplar Bluff Regional Medical Center

  • Community/Retail Pharmacy
  • Piedmont, MO
  • NPI 1205879426
  NPD (past)
• Poplar Bluff Regional Medical Center LLC

  • General Acute Care Hospital
  • Poplar Bluff, MO
  • NPI 1700831724

  Nurse Anesthetist, Certified Registered

  NPD (past)
• Poplar Bluff Regional Medical Center LLC

  • Rural Health Clinic/Center
  • Malden, MO
  • NPI 1801839147
  NPD (past)

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

• Unitypoint Health - Marshalltown

  • General Acute Care Hospital
  • Marshalltown, IA
  • NPI 1629503057
  Care Compare affiliation

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

{
    "created_epoch": "1177372800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1164640926",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12747 FOXWOOD PT",
            "city": "POPLAR BLUFF",
            "state": "MO",
            "postal_code": "639017746",
            "telephone_number": "573-778-3870"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2620 N WESTWOOD BLVD",
            "city": "POPLAR BLUFF",
            "state": "MO",
            "postal_code": "639013396",
            "telephone_number": "573-718-2710"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FALTYS",
        "first_name": "SHANE",
        "middle_name": "D",
        "credential": "CRNA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-04-24",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MO",
            "license": "2004031200",
            "primary": true
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "IA",
            "license": "D-102109",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Eye Surgery Consultants, LLP
• Kathleen L Fain
• Clea Marie Fairaizl, LCSW
• Michael Scott Fairlamb
• Roger Dean Faltys, CRNA
• Family Counseling Center, Inc.
• Family Counseling Center, Inc.
• Family Counseling Center, Inc.
• Family Counseling Center, Inc.
• Family Counseling Center, Inc.

• Certified Registered Nurse Anesthetist in Poplar Bluff, MO
• Providers in Poplar Bluff, MO by specialty
• Certified Registered Nurse Anesthetist in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.