NPIMap

Individual provider Active NPI

Shanna Gates Stoter, CRNA

  • Certified Registered Nurse Anesthetist
  • Winston Salem, NC
National Provider Identifier
1205818564
Registry record updated Apr 28, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
159591 Issued in NC
Practice address
Medical Center Boulevard
Winston Salem, NC 27157-0001
Phone
(336) 716-3069
NPI assigned
Nov 14, 2005
Last updated
Apr 28, 2015By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 28, 2015

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 159591 NC Primary

Addresses

Primary practice location

Medical Center Boulevard
Winston Salem, NC 27157-0001

Mailing address

2500 Robinhood Rd
Winston Salem, NC 27106-5804
Phone (336) 414-7469

Other identifiers 1

IdentifierTypeStateIssuer
8051872MedicaidNC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC, GA, SC3 enrollments

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
I20031222000586 NC Practitioner - Certified Registered Nurse Anesthetist (Crna) 4183522600 Reassigns benefits to 5 organizations
I20190930002476 GA Practitioner - Certified Registered Nurse Anesthetist (Crna) 4183522600 Reassigns benefits to 1 organization
I20191114003560 SC Practitioner - Certified Registered Nurse Anesthetist (Crna) 4183522600 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Anesthesia Care Services PAGroup PAC ID 7012937105, 54 clinicians
Piedmont Sedation Associates, LLCGroup PAC ID 9436649878, 19 clinicians

Practice addresses (Care Compare)

1606 Ashley River Rd
Charleston, SC 29407-5902
Phone (843) 763-0503

445 Pineview Dr
Suite 240
Kernersville, NC 27284-3818
Phone (336) 914-5114

875 Bethesda Rd
Winston Salem, NC 27103-3026
Phone (334) 448-2427

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
159591NCMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Eagle Physicians and Associates PA Current Accepting new patients
Piedmont Triad Anesthesia, PA Nurse Anesthetist, Certified Registered CurrentSince Dec 1, 2022 Accepting new patients
Salem Professional Anesthesia Services PC Nurse Anesthetist, Certified Registered CurrentSince May 20, 2015 Accepting new patients
Eagle Physicians and Associates PA CurrentSince Jul 1, 2018 Accepting new patients
Eagle Physicians and Associates PA CurrentSince Jul 1, 2018 Accepting new patients
Piedmont Sedation Associates, LLC Nurse Anesthetist, Certified Registered CurrentSince Sep 22, 2025 Accepting new patients

Locations

128 Peachtree Ln
Ste B
Advance, NC 27006
Phone (336) 998-3396

1002 N Church St
Ste 201
Greensboro, NC 27401
Phone (336) 378-0713

3812 N Elm St
Greensboro, NC 27455
Phone (336) 294-1833

445 Pineview Dr
Ste 240
Kernersville, NC 27284
Phone (336) 448-2427

145 Kimel Park Dr
Ste 120
Winston Salem, NC 27103
Phone (336) 277-1770

1901 S Hawthorne Rd
Ste 308
Winston Salem, NC 27103
Phone (336) 448-2427

875 Bethesda Rd
Winston Salem, NC 27103
Phone (336) 448-2427

Organizations & group practices 7

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.

Hospital & facility affiliations 14

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

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1131926400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1430179200000",
    "number": "1205818564",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2500 ROBINHOOD RD",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271065804",
            "telephone_number": "336-414-7469"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "MEDICAL CENTER BOULEVARD",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271570001",
            "telephone_number": "336-716-3069"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STOTER",
        "first_name": "SHANNA",
        "middle_name": "GATES",
        "name_prefix": "Mrs.",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-11-14",
        "last_updated": "2015-04-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "NC",
            "license": "159591",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8051872",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Winston Salem, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 2015; 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.