NPIMap

Individual provider Active NPI

John N Shellenberger, CRNA

  • Certified Registered Nurse Anesthetist
  • Syracuse, NY
National Provider Identifier
1225087505
Registry record updated Sep 5, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
300825 Issued in NY
Practice address
736 Irving Ave
Syracuse, NY 13210-1687
Phone
(315) 470-7828
Fax
(315) 470-5811
NPI assigned
May 6, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 5, 2013

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 300825 NY Primary

Addresses

Primary practice location

736 Irving Ave
Syracuse, NY 13210-1687

Mailing address

PO Box 608
Jordan, NY 13080
Phone (731) 415-3389

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
35952KYMDPsychiatry Physician
300825NYMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Blair County Anesthesia, P.C. Past Accepting new patients
Spectrum Healthcare Partners, PA Past Accepting new patients
Anesthesia Care Enterprises, LLC Nurse Anesthetist, Certified Registered Past Accepting new patients
Lexington Anesthesia Associates, Inc. Nurse Anesthetist, Certified Registered Past Accepting new patients
American Anesthesiology Associates of Virginia, Inc Past Accepting new patients
Baba Abudu MD PA Past Accepting new patients
Commonwealth Anesthesia, PSC Nurse Anesthetist, Certified Registered Past Accepting new patients
Mercy Tyler Health Systems Past Accepting new patients
Mercy Tyler Hospital Past Accepting new patients
Eastern Panhandle Anesthesia Associates Past Accepting new patients
Penobscot Valley Hospital Past Accepting new patients
Pineville Community Hospital Association, Inc. Past Accepting new patients
Pineville Community Hospital Association, Inc. Past Accepting new patients
Columbia/HCA John Randolph, Inc. Past Accepting new patients

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/5664/brand/1/csg/1/fhir/r4
  • FHIR API: https://fhir-usa.unify.chbase.com/org/penob-eadbba22

Organizations & group practices 14

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.

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1146873600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1378339200000",
    "number": "1225087505",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 608",
            "city": "JORDAN",
            "state": "NY",
            "postal_code": "13080",
            "telephone_number": "731-415-3389"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "736 IRVING AVE",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132101687",
            "telephone_number": "315-470-7828",
            "fax_number": "315-470-5811"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHELLENBERGER",
        "first_name": "JOHN",
        "middle_name": "N",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-06",
        "last_updated": "2013-09-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "NY",
            "license": "300825",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Syracuse, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 5, 2013; 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.