Individual provider Active NPI

Shelby Waugh

  • Certified Registered Nurse Anesthetist
  • Bradenton, FL
National Provider Identifier
1235882002
Registry record updated Jun 7, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
11019684 Issued in FL
Practice address
2020 59TH St W
Bradenton, FL 34209-4604
Phone
(941) 792-6611
NPI assigned
Feb 1, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 7, 2022

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 RN9385535 FL
Certified Registered Nurse Anesthetist 367500000X 11019684 FL Primary

Addresses

Primary practice location

2020 59TH St W
Bradenton, FL 34209-4604

Mailing address

2588 17TH Ave N
Saint Petersburg, FL 33713-4926
Phone (727) 475-0748

Other practice location 1

2588 17th Ave N
Saint Petersburg, FL 33713-4926
Phone (727) 475-0748

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220625000449 FL Practitioner - Certified Registered Nurse Anesthetist (Crna) 7810376522 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Capital Anesthesia Solutions of Florida II, LLCGroup PAC ID 7911323720, 327 clinicians
Anesthesia Dynamics LLCGroup PAC ID 3779832530, 883 clinicians
Office Anesthesia StaffingGroup PAC ID 6901285709, 62 clinicians

Practice addresses (Care Compare)

2020 59TH St W
HCA Florida Blake Hospital
Bradenton, FL 34209-4604
Phone (941) 792-6611

2275 N Central Ave
Kissimmee, FL 34741-2342
Phone (888) 851-4642

540 The Rialto
Venice, FL 34285-2900
Phone (941) 485-7711

Hospital & facility affiliations

  • HCA Florida Blake Hospital Hospital, Bradenton, FL, CCN 100213

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RN9385535FLMDRegistered Nurse
11019684FLMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Anesthesia Dynamics LLC Nurse Anesthetist, Certified Registered CurrentSince Jan 13, 2026 Accepting new patients
Capital Anesthesia Solutions of Florida II, LLC CurrentSince Oct 1, 2022 Accepting new patients
Office Anesthesia Staffing Nurse Anesthetist, Certified Registered CurrentSince Jan 17, 2026 Accepting new patients

Locations

2020 59th St W
Bradenton, FL 34209
Phone (813) 798-6303

665 Del Prado Blvd S
Cape Coral, FL 33990
Phone (239) 772-3636

6412 W Gulf To Lake Hwy
Crystal River, FL 34429
Phone (352) 563-0023

1109 US Highway 19
Holiday, FL 34691
Phone (727) 934-5705

2275 N Central Ave
Kissimmee, FL 34741
Phone (407) 570-0573

8330 Lakewood Ranch Blvd
Lakewood Ranch, FL 34202
Phone (941) 666-8757

9035 Sunset Dr
Ste 200
Miami, FL 33173
Phone (786) 615-6210

8300 Collier Blvd
Naples, FL 34114
Phone (239) 354-6000

1325 Belcher Rd
Palm Harbor, FL 34683
Phone (816) 500-0021

540 The Rialto
Venice, FL 34285
Phone (866) 481-2553

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 and National Provider Directory roles.

Hospital & facility affiliations 1

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": "1643673600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654560000000",
    "number": "1235882002",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2588 17TH AVE N",
            "city": "SAINT PETERSBURG",
            "state": "FL",
            "postal_code": "337134926",
            "telephone_number": "727-475-0748"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2020 59TH ST W",
            "city": "BRADENTON",
            "state": "FL",
            "postal_code": "342094604",
            "telephone_number": "941-792-6611"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2588 17th Ave N",
            "address_purpose": "LOCATION",
            "city": "Saint Petersburg",
            "state": "FL",
            "postal_code": "337134926",
            "country_code": "US",
            "telephone_number": "727-475-0748",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WAUGH",
        "first_name": "SHELBY",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-02-01",
        "last_updated": "2022-06-07",
        "certification_date": "2022-05-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "FL",
            "license": "RN9385535",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "FL",
            "license": "11019684",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bradenton, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 7, 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.