Individual provider Active NPI

Janice Elizabeth Ekberg-Shelley, CRNA

  • Certified Registered Nurse Anesthetist
  • Charlottesville, VA
National Provider Identifier
1316922826
Registry record updated Dec 10, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
0024072985 Issued in VA
Practice address
1215 Lee St
Charlottesville, VA 22908-0816
Phone
(434) 982-0655
NPI assigned
Dec 8, 2005
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 10, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 0001072985 VA
Certified Registered Nurse Anesthetist 367500000X 0024072985 VA Primary

Addresses

Primary practice location

1215 Lee St
Charlottesville, VA 22908-0816

Mailing address

2195 Westover Dr
Charlottesville, VA 22901-9503
Phone (434) 812-1008

Other identifiers 1

IdentifierTypeStateIssuer
8938229MedicaidVA

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

LicenseStateTypeSpecialty
0001072985VAMDRegistered Nurse
0024072985VAMDCertified Registered Nurse Anesthetist

NPI Registry JSON

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

{
    "created_epoch": "1134000000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1386633600000",
    "number": "1316922826",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2195 WESTOVER DR",
            "city": "CHARLOTTESVILLE",
            "state": "VA",
            "postal_code": "229019503",
            "telephone_number": "434-812-1008",
            "fax_number": "434-823-1008"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1215 LEE ST",
            "city": "CHARLOTTESVILLE",
            "state": "VA",
            "postal_code": "229080816",
            "telephone_number": "434-982-0655"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EKBERG-SHELLEY",
        "first_name": "JANICE",
        "middle_name": "ELIZABETH",
        "credential": "CRNA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-12-08",
        "last_updated": "2013-12-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "VA",
            "license": "0001072985",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "VA",
            "license": "0024072985",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8938229",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlottesville, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 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.