Individual provider Active NPI

Claudine A. Shank, CRNA

  • Certified Registered Nurse Anesthetist
  • Colorado Springs, CO
National Provider Identifier
1174517494
Registry record updated Nov 6, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
APN.0004377-CRNA Issued in CO
Practice address
3631 Tuscanna GRV
Colorado Springs, CO 80920-2820
Phone
(719) 219-9573
Fax
(719) 219-9573
NPI assigned
Aug 31, 2005
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 6, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 114275 CO
Certified Registered Nurse Anesthetist 367500000X APN.0004377-CRNA CO Primary

Addresses

Primary practice location

3631 Tuscanna GRV
Colorado Springs, CO 80920-2820

Mailing address

3631 Tuscanna GRV
Colorado Springs, CO 80920-2820
Phone (719) 219-9573

Other identifiers 1

IdentifierTypeStateIssuer
200508120MedicaidIN

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20061004000052 CO Practitioner - Certified Registered Nurse Anesthetist (Crna) 5092703892 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
114275COMDRegistered Nurse
APN.0004377-CRNACOMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Diehl Anesthesia Inc CurrentSince Oct 1, 2019 Accepting new patients
Colorado Personnel Resources Inc Past Accepting new patients
University of Washington Past Accepting new patients
Complete Care Office Anesthesia LLC Past Accepting new patients

Locations

9395 Crown Crest Blvd
Parker, CO 80138
Phone (303) 269-4000

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1125446400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1572998400000",
    "number": "1174517494",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3631 TUSCANNA GRV",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809202820",
            "telephone_number": "719-219-9573",
            "fax_number": "719-219-9573"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3631 TUSCANNA GRV",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809202820",
            "telephone_number": "719-219-9573",
            "fax_number": "719-219-9573"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHANK",
        "first_name": "CLAUDINE",
        "middle_name": "A.",
        "name_prefix": "Mrs.",
        "credential": "CRNA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-08-31",
        "last_updated": "2019-11-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CO",
            "license": "114275",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "CO",
            "license": "APN.0004377-CRNA",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200508120",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Colorado Springs, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.