Active NPI
Craig Shanewise
- Certified Registered Nurse Anesthetist
- Durham, NC
National Provider Identifier
1275682296
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Certified Registered Nurse Anesthetist
- License
- 48119
- Practice address
- Erwin Rd
Durham, NC 27710-0001 - Phone
- (919) 684-3595
- NPI assigned
- Jan 9, 2007
- Last updated
- Feb 20, 2008
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Certified Registered Nurse Anesthetist | 367500000X | 48119 | NC | Primary |
Addresses
Primary practice location
Erwin Rd
Durham, NC 27710-0001
Mailing address
Erwin Rd
Durham, NC 27710-0001
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 8051908 | Medicaid | NC |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 48119 | NC | MD | Certified Registered Nurse Anesthetist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1168300800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1203465600000",
"number": "1275682296",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "ERWIN RD",
"city": "DURHAM",
"state": "NC",
"postal_code": "277100001"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "ERWIN RD",
"city": "DURHAM",
"state": "NC",
"postal_code": "277100001",
"telephone_number": "919-684-3595"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHANEWISE",
"first_name": "CRAIG",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-01-09",
"last_updated": "2008-02-20",
"status": "A"
},
"taxonomies": [
{
"code": "367500000X",
"taxonomy_group": "",
"desc": "Nurse Anesthetist, Certified Registered",
"state": "NC",
"license": "48119",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "8051908",
"state": "NC"
}
],
"endpoints": [],
"other_names": []
}Other providers in Durham, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.