Individual provider Active NPI

Ana R Shanley

  • Certified Registered Nurse Anesthetist
  • Bridgeport, CT
National Provider Identifier
1194731810
Registry record updated Nov 10, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
E33793 Issued in CT
Practice address
267 Grant St
Bridgeport Anesthesia Associates, PC
Bridgeport, CT 06610-2805
Phone
(203) 384-3000
NPI assigned
Aug 1, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 10, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X E33793 CT Primary

Addresses

Primary practice location

267 Grant St
Bridgeport Anesthesia Associates, PC
Bridgeport, CT 06610-2805

Mailing address

7365 Main St
Suite 310
Stratford, CT 06614-1300

Other identifiers 1

IdentifierTypeStateIssuer
004081725MedicaidCT

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20071217000352 CT Practitioner - Certified Registered Nurse Anesthetist (Crna) 1557451309 Reassigns benefits to 2 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Bridgeport Anesthesia Associates, P.C. Nurse Anesthetist, Certified Registered CurrentSince Jan 1, 2006 Accepting new patients
Integrated Anesthesia Associates LLC Nurse Anesthetist, Certified Registered CurrentSince May 18, 2013 Accepting new patients
Fairfield Anesthesia Associates LLC Past Accepting new patients

Locations

267 Grant St
Bridgeport, CT 06610
Phone (203) 384-3170

80 Seymour St
Hartford, CT 06106
Phone (860) 545-2249

60 Wellington Rd
Milford, CT 06461
Phone (203) 878-2010

2 Corporate Dr
Ste 955
Shelton, CT 06484
Phone (203) 929-7375

778 Long Ridge Rd
Stamford, CT 06902
Phone (203) 322-2400

7365 Main St
Ste 310
Stratford, CT 06614
Phone (203) 384-3174

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1154390400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1257811200000",
    "number": "1194731810",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7365 MAIN ST",
            "address_2": "SUITE 310",
            "city": "STRATFORD",
            "state": "CT",
            "postal_code": "066141300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "267 GRANT ST",
            "address_2": "BRIDGEPORT ANESTHESIA ASSOCIATES, PC",
            "city": "BRIDGEPORT",
            "state": "CT",
            "postal_code": "066102805",
            "telephone_number": "203-384-3000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHANLEY",
        "first_name": "ANA",
        "middle_name": "R",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-01",
        "last_updated": "2009-11-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "CT",
            "license": "E33793",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004081725",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bridgeport, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 2009; 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.