Shelley J Kudialis, CRNA

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

RN0000158056 Issued in TN

Practice address

1114 Sunset Dr
Suite 4
Johnson City, TN 37604-2969

Phone

(423) 283-0776

Fax

(423) 283-0549

NPI assigned

Mar 7, 2007

Last updated

Oct 29, 2019By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in TN, FL2 enrollments

Enrollment records 2

Specialty

Certified Registered Nurse Anesthetist (Crna)

Education

Other, 1994

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

West Florida Anesthesia Associates LLCGroup PAC ID 7517231186, 43 clinicians

Anesthesia Dynamics LLCGroup PAC ID 3779832530, 883 clinicians

CRH Anesthesia of Florida LLCGroup PAC ID 9931420544, 22 clinicians

SRQ Anesthesia LLCGroup PAC ID 8820576911, 21 clinicians

SWF Anesthesia, LLCGroup PAC ID 3072917111, 7 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Registered Nurse

State licenses

Practice roles

Locations (25 of 33)

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.

• Anesthesia Dynamics LLC

  • Anesthesiology Physician
  • Bradenton, FL
  • NPI 1073001012

  Nurse Anesthetist, Certified Registered

  Medicare reassignment Care Compare group NPD
• CRH Anesthesia of Florida LLC

  • Certified Registered Nurse Anesthetist
  • Tampa, FL
  • NPI 1235521618

  Nurse Anesthetist, Certified Registered

  Medicare reassignment Care Compare group NPD
• SRQ Anesthesia LLC

  • Certified Registered Nurse Anesthetist
  • Sarasota, FL
  • NPI 1447115977

  Nurse Anesthetist, Certified Registered

  Medicare reassignment Care Compare group NPD
• West Florida Anesthesia Associates LLC

  • Certified Registered Nurse Anesthetist
  • Fort Myers, FL
  • NPI 1962926568

  Nurse Anesthetist, Certified Registered

  Medicare reassignment Care Compare group NPD
• SWF Anesthesia, LLC

  • Certified Registered Nurse Anesthetist
  • Fort Myers, FL
  • NPI 1588236954
  Medicare reassignment Care Compare group
• Resource Anesthesia, P.C.

  • Certified Registered Nurse Anesthetist
  • Lenoir City, TN
  • NPI 1033162045

  Nurse Anesthetist, Certified Registered

  Medicare reassignment NPD
• Ams National LLC

  • Anesthesiology Physician
  • Pensacola, FL
  • NPI 1316330830

  Nurse Anesthetist, Certified Registered

  Medicare reassignment NPD
• Amsurg Citrus Anesthesia LLC

  • Anesthesiology Physician
  • Orlando, FL
  • NPI 1255774212
  Medicare reassignment NPD
• Anesthesia Associates of Ocala, LLC

  • Anesthesiology Physician
  • Ocala, FL
  • NPI 1962808287
  Medicare reassignment NPD
• Anesthesia Associates of Southwest Florida LLC

  • Certified Registered Nurse Anesthetist
  • Venice, FL
  • NPI 1881652899

  Nurse Anesthetist, Certified Registered

  Medicare reassignment NPD
• Anesthesia Services Plus Inc.

  • Certified Registered Nurse Anesthetist
  • Fort Myers, FL
  • NPI 1205230703

  Nurse Anesthetist, Certified Registered

  Medicare reassignment NPD
• Jonathan M Frantz, MD PA

  dba Frantz EyeCare

  • Ophthalmology Physician
  • Fort Myers, FL
  • NPI 1033199609
  Medicare reassignment NPD

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

{
    "created_epoch": "1173225600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1572307200000",
    "number": "1265562144",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "230 LAKE RIDGE DR",
            "city": "JONESBOROUGH",
            "state": "TN",
            "postal_code": "376594798",
            "telephone_number": "423-438-0521"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1114 SUNSET DR",
            "address_2": "SUITE 4",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376042969",
            "telephone_number": "423-283-0776",
            "fax_number": "423-283-0549"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUDIALIS",
        "first_name": "SHELLEY",
        "middle_name": "J",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-07",
        "last_updated": "2019-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "FL",
            "license": "APRN9387933",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "TN",
            "license": "RN0000158056",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PENDING",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Karsyn Krob
• Kroger Limited Partnership I (Kroger Pharmacy)
• Kroger Limited Partnership I (Kroger Pharmacy)
• Daniel Robert Kubisiak, D.PH
• Kathleen Anne Kuczynski, DSW MSW
• Susan Mahmoud Khaled Kullab, MD
• P Lucy Kumar, MD
• Varun Kumar
• Krishna Prasad Kurpad, MBBS
• Christen Marissa Kuykendall, M.S., CCC-SLP

• Certified Registered Nurse Anesthetist in Johnson City, TN
• Providers in Johnson City, TN by specialty
• Certified Registered Nurse Anesthetist in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 2019; 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.