Shenandoah TX Endoscopy ASC LLC

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

Legal business name

SHENANDOAH TX ENDOSCOPY ASC LLC

Practice address

111 Vision Park Blvd
Suite 160
Shenandoah, TX 77384-3002

Phone

(936) 321-8910

Fax

(936) 321-8913

NPI assigned

Aug 17, 2009

Organization subpart

No

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

Authorized official

Name

Mr. Phillip A Clendenin

Title

President

Phone

(615) 665-1283

Specialties & licenses 1

Addresses

Other identifiers 10

Other names 1

• Woodlands Endoscopy Center Doing business as

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

{
    "created_epoch": "1250467200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1694044800000",
    "number": "1316179963",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20 BURTON HILLS BLVD",
            "address_2": "SUITE 500",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372156197",
            "telephone_number": "615-240-3720",
            "fax_number": "615-234-1720"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 VISION PARK BLVD",
            "address_2": "SUITE 160",
            "city": "SHENANDOAH",
            "state": "TX",
            "postal_code": "773843002",
            "telephone_number": "936-321-8910",
            "fax_number": "936-321-8913"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHENANDOAH TX ENDOSCOPY ASC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-08-17",
        "last_updated": "2023-09-07",
        "status": "A",
        "authorized_official_last_name": "CLENDENIN",
        "authorized_official_first_name": "PHILLIP",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "615-665-1283",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CRNA SANDRA LENHART",
            "identifier": "8L22271",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CRNA JULIA MARTIN",
            "identifier": "8F33700",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CRNA GLYNN COOPER",
            "identifier": "8L25451",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CRNA  JAMES BODOH",
            "identifier": "8L26184",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CRNA ROTH OWEN",
            "identifier": "8L21238",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CRNA JAMES MATTINGLY",
            "identifier": "8L22350",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CRNA ESTHER SCOGGIN",
            "identifier": "8F33699",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CRNA DUANE RIEGEL",
            "identifier": "8F33701",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CRNA DANA FISHER",
            "identifier": "8F33698",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CRNA BRENDA MCCALL",
            "identifier": "8L22270",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Woodlands Endoscopy Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Erin Sharpe, PA-C
• Shaun S. Varghese, M.D., PLLC
• Kevin Lu Shen, MD
• Shenandoah Imaging, LP
• Shenandoah Surgical Associates LLC
• Shenandoah TX Endoscopy ASC LLC
• Jason Wayne Sherrell, DMD
• Sokuntheary Kep Sherwani, AGACNP-BC
• Christine Shiang
• Page A Shields

• Certified Registered Nurse Anesthetist in Shenandoah, TX
• Providers in Shenandoah, 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 Sep 7, 2023; 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.