Kyle M Shadle, CRNA

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

710328 Issued in TX

Practice address

1708 Coit Rd
Suite 220a
Plano, TX 75075-5024

Phone

(972) 596-6400

Fax

(972) 867-4766

NPI assigned

Sep 26, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Jeffrey M Shadle MD PA

  • Family Medicine Physician
  • Plano, TX
  • NPI 1942368980
  NPD (past)
• Anesthesia Unlimited Inc

  • Anesthesiology Physician
  • Panama City, FL
  • NPI 1871519884
  NPD (past)

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

{
    "created_epoch": "1159228800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1358294400000",
    "number": "1265533434",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1708 COIT RD",
            "address_2": "SUITE 220A",
            "city": "PLANO",
            "state": "TX",
            "postal_code": "750755024"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1708 COIT RD",
            "address_2": "SUITE 220A",
            "city": "PLANO",
            "state": "TX",
            "postal_code": "750755024",
            "telephone_number": "972-596-6400",
            "fax_number": "972-867-4766"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHADLE",
        "first_name": "KYLE",
        "middle_name": "M",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-26",
        "last_updated": "2013-01-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "TX",
            "license": "710328",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FL CRNA LICENSE",
            "identifier": "ARNP9186616",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF FL #",
            "identifier": "G3766",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mohamed Shabana
• Tawfik A. Shabana, M.D.
• Shaiyad Shabbi, PHARMD
• Shadi Najd LC
• Jeffrey M Shadle, MD
• Shafa Mobile Diagnostic Management Inc
• Stacey M Shafenberg, LPA
• Jordan Shafer
• Linh Shafer, RN
• Shah PMR PLLC

• Certified Registered Nurse Anesthetist in Plano, TX
• Providers in Plano, TX by specialty
• Certified Registered Nurse Anesthetist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 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.