Individual provider Active NPI

Shane Henning, CRNA

  • Certified Registered Nurse Anesthetist
  • Houston, TX
National Provider Identifier
1285388165
Registry record updated Feb 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
1070121 Issued in TX
Practice address
6720 Bertner Ave
Houston, TX 77030-2604
Phone
(823) 355-2666
Fax
(972) 233-3666
NPI assigned
Feb 9, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 7, 2023

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 1070121 TX Primary

Addresses

Primary practice location

6720 Bertner Ave
Houston, TX 77030-2604

Mailing address

6720 Bertner Ave
Houston, TX 77030-2604
Phone (823) 355-2666

Other practice location 1

6606 Lbj Fwy Ste 200
Dallas, TX 75240-6524
Phone (972) 715-5000

Other practice location 2

12222 Merit Dr Ste 600
Dallas, TX 75251-3294
Phone (972) 715-5000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA, OR2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20230626001590 WA Practitioner - Certified Registered Nurse Anesthetist (Crna) 6406240506 Reassigns benefits to 2 organizations
I20250306002326 OR Practitioner - Certified Registered Nurse Anesthetist (Crna) 6406240506 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Anesthesia Associates Northwest LLCGroup PAC ID 7618908484, 80 clinicians
Columbia Anesthesia Group P SGroup PAC ID 8426954322, 71 clinicians

Practice addresses (Care Compare)

120 NW 14TH Ave
Suite 200
Portland, OR 97209-2642
Phone (503) 771-1883

400 NE Mother Joseph Place
Vancouver, WA 98664-3200
Phone (360) 256-2000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
73.51 of 100Reported as group
Quality
68.84
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Cascadia Interventional Anesthesia Nurse Anesthetist, Certified Registered CurrentSince Aug 1, 2025 Accepting new patients
Anesthesia Associates Northwest LLC CurrentSince Jan 27, 2025 Accepting new patients
Columbia Anesthesia Group P S CurrentSince Jun 1, 2023 Accepting new patients

Locations

120 NW 14th Ave
Ste 200
Portland, OR 97209
Phone (503) 771-1883

625 9th Ave
Ste 150
Longview, WA 98632
Phone (360) 442-7900

400 NE Mother Joseph Pl
Vancouver, WA 98664
Phone (360) 514-2000

505 NE 87th Ave
Ste 210
Vancouver, WA 98664
Phone (360) 828-5396

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 2

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": "1644364800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675728000000",
    "number": "1285388165",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6720 BERTNER AVE",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770302604",
            "telephone_number": "823-355-2666",
            "fax_number": "972-233-3666"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6720 BERTNER AVE",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770302604",
            "telephone_number": "823-355-2666",
            "fax_number": "972-233-3666"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6606 Lbj Fwy Ste 200",
            "address_purpose": "LOCATION",
            "city": "Dallas",
            "state": "TX",
            "postal_code": "752406524",
            "country_code": "US",
            "telephone_number": "972-715-5000",
            "fax_number": "972-715-9976",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "12222 Merit Dr Ste 600",
            "address_purpose": "LOCATION",
            "city": "Dallas",
            "state": "TX",
            "postal_code": "752513294",
            "country_code": "US",
            "telephone_number": "972-715-5000",
            "fax_number": "972-715-9976",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HENNING",
        "first_name": "SHANE",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-02-09",
        "last_updated": "2023-02-07",
        "certification_date": "2023-02-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "TX",
            "license": "1070121",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 2023; 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.