Individual provider Active NPI

Jami D Shockey, CRNA

  • Certified Registered Nurse Anesthetist
  • Lees Summit, MO
National Provider Identifier
1194389627
Registry record updated Jun 12, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
2019019035 Issued in MO
Practice address
100 NE Saint Lukes Blvd
Lees Summit, MO 64086-6000
Phone
(816) 347-5097
Fax
(816) 347-5045
NPI assigned
Apr 30, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 12, 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 2013019719 MO
Certified Registered Nurse Anesthetist 367500000X 2019019035 MO Primary

Addresses

Primary practice location

100 NE Saint Lukes Blvd
Lees Summit, MO 64086-6000

Mailing address

PO Box 412431
Kansas City, MO 64141-2431
Phone (816) 347-5097

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2013019719MOMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1556582400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1560297600000",
    "number": "1194389627",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 412431",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641412431",
            "telephone_number": "816-347-5097",
            "fax_number": "816-347-5045"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 NE SAINT LUKES BLVD",
            "city": "LEES SUMMIT",
            "state": "MO",
            "postal_code": "640866000",
            "telephone_number": "816-347-5097",
            "fax_number": "816-347-5045"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHOCKEY",
        "first_name": "JAMI",
        "middle_name": "D",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-04-30",
        "last_updated": "2019-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MO",
            "license": "2013019719",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MO",
            "license": "2019019035",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lees Summit, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.