Individual provider Active NPI

Shawn P. Ross, CRNA

  • Certified Registered Nurse Anesthetist
  • Tullahoma, TN
National Provider Identifier
1194748673
Registry record updated Dec 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
11718 Issued in TN
Practice address
1801 N Jackson St
Tullahoma, TN 37388-2201
Phone
(931) 393-7933
NPI assigned
Jul 25, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 21, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X RN0000152627 TN
Certified Registered Nurse Anesthetist 367500000X 11718 TN Primary

Addresses

Primary practice location

1801 N Jackson St
Tullahoma, TN 37388-2201

Mailing address

744 W Michigan Ave
Jackson, MI 49201-1909
Phone (800) 242-1131

Other practice location 1

1901 Clinch Ave
Knoxville, TN 37916-2307
Phone (865) 541-1111

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070618000404 TN Practitioner - Certified Registered Nurse Anesthetist (Crna) 4486610417 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Resource Anesthesia, P.C.Group PAC ID 1254228141, 71 clinicians
Covenant Anesthesia Group PCGroup PAC ID 6901795830, 231 clinicians

Practice addresses (Care Compare)

105 N Meadows Dr
Athens, TN 37303-4172
Phone (423) 649-3300

1901 Clinch Ave
Knoxville, TN 37916-2307
Phone (865) 331-1111

9352 Park W Blvd
Knoxville, TN 37923-4325
Phone (865) 373-1000

990 Oak Ridge Tpke
Oak Ridge, TN 37830-6976
Phone (865) 835-3560

Hospital & facility affiliations

  • Parkwest Medical Center Hospital, Knoxville, TN, CCN 440173
  • Fort Sanders Regional Medical Center Hospital, Knoxville, TN, CCN 440125

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
11718TNMDAnesthesiology Physician
RN0000152627TNMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Covenant Anesthesia Group, PC CurrentSince Feb 27, 2024 Accepting new patients
American Anesthesiology of Tennessee, P.C. Nurse Anesthetist, Certified Registered CurrentSince Dec 22, 2022 Accepting new patients
American Anesthesiology of Tennessee, P.C. CurrentSince Dec 22, 2022 Accepting new patients
Resource Anesthesia, P.C. Nurse Anesthetist, Certified Registered CurrentSince Jan 1, 2025 Accepting new patients
Medstream Anesthesia PLLC Nurse Anesthetist, Certified Registered CurrentSince Oct 2, 2017 Accepting new patients
Tennessee Valley Anesthesia PLLC CurrentSince Sep 25, 2023 Accepting new patients
Sarasota Anesthesiologists, PA PastSince Jan 26, 2004 Accepting new patients
Highland Rim Anesthesia, P.C. Past Accepting new patients

Locations

1305 Walt Whitman Rd
Ste 300
Melville, NY 11747
Phone (516) 370-3796

105 N Meadows Dr
Athens, TN 37303
Phone (423) 649-3300

5751 Uptain Rd
Ste 100
Chattanooga, TN 37411
Phone (423) 855-8406

421 S Main St
Crossville, TN 38555
Phone (931) 260-1465

1819 Clinch Ave
Ste 206
Knoxville, TN 37916
Phone (865) 522-2949

1901 Clinch Ave
Knoxville, TN 37916
Phone (865) 331-1111

9430 Park West Blvd
Ste 210
Knoxville, TN 37923
Phone (865) 531-0494

9352 Park West Blvd
Knoxville, TN 37923
Phone (865) 373-1000

210 Fort Sanders West Blvd
Ste 200
Knoxville, TN 37922
Phone (865) 531-5222

Dept 888089
Knoxville, TN 37995

9300 Park West Blvd
Knoxville, TN 37923
Phone (865) 427-4040

550 Fort Loudon Medical Center Dr
#C
Lenoir City, TN 37772

990 Oak Ridge Tpke
Oak Ridge, TN 37830
Phone (865) 481-1000

1850 Old Knoxville Rd
Tazewell, TN 37879
Phone (423) 526-2137

1801 N Jackson St
Tullahoma, TN 37388
Phone (931) 393-3000

Organizations & group practices 8

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.

Hospital & facility affiliations 2

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

NPI Registry JSON

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

{
    "created_epoch": "1153785600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1671580800000",
    "number": "1194748673",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "744 W MICHIGAN AVE",
            "city": "JACKSON",
            "state": "MI",
            "postal_code": "492011909",
            "telephone_number": "800-242-1131"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1801 N JACKSON ST",
            "city": "TULLAHOMA",
            "state": "TN",
            "postal_code": "373882201",
            "telephone_number": "931-393-7933"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1901 Clinch Ave",
            "address_purpose": "LOCATION",
            "city": "Knoxville",
            "state": "TN",
            "postal_code": "379162307",
            "country_code": "US",
            "telephone_number": "865-541-1111",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROSS",
        "first_name": "SHAWN",
        "middle_name": "P.",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-25",
        "last_updated": "2022-12-21",
        "certification_date": "2022-12-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "TN",
            "license": "RN0000152627",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "TN",
            "license": "11718",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tullahoma, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 21, 2022; 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.