Shady Grove Anesthesia Associate LLC

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

R115576 Issued in MD

Legal business name

SHADY GROVE ANESTHESIA ASSOCIATE LLC

Practice address

9600 Blackwell Road
Suite 500
Rockville, MD 20850-6478

Phone

(301) 340-1188

Fax

(301) 340-1612

NPI assigned

Apr 23, 2013

Organization subpart

Yes

Parent organization

SHADY GROVE FERTILITY RSCAs reported in NPPES

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

Authorized official

Name

Shelly Shapiro

Title

Chief Financial Officer

Phone

(301) 545-1407

Specialties & licenses 1

Addresses

Part of

Shady Grove Fertility Reproductive Science Center

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

{
    "created_epoch": "1366675200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1518739200000",
    "number": "1326482126",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9600 BLACKWELL RD STE 500",
            "city": "ROCKVILLE",
            "state": "MD",
            "postal_code": "208503783",
            "telephone_number": "301-340-1188",
            "fax_number": "301-340-1612"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9600 BLACKWELL ROAD",
            "address_2": "SUITE 500",
            "city": "ROCKVILLE",
            "state": "MD",
            "postal_code": "208506478",
            "telephone_number": "301-340-1188",
            "fax_number": "301-340-1612"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHADY GROVE ANESTHESIA ASSOCIATE LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SHADY GROVE FERTILITY RSC",
        "enumeration_date": "2013-04-23",
        "last_updated": "2018-02-16",
        "status": "A",
        "authorized_official_last_name": "SHAPIRO",
        "authorized_official_first_name": "SHELLY",
        "authorized_official_title_or_position": "CHIEF FINANCIAL OFFICER",
        "authorized_official_telephone_number": "301-545-1407"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MD",
            "license": "R115576",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Hera Shabiu
• Grace Shadid
• Joyce Shadid
• Shady Grove Adventist Nursing & Rehabilitation Center Inc
• Shady Grove Andrology Center LLC
• Shady Grove Center for Preimplantation Genetics
• Shady Grove Children'S Gad, LLC
• Shady Grove Children'S Gad, LLC
• Shady Grove Children'S Surgery Center, LLC
• Shady Grove Dental Center, LLC

• Certified Registered Nurse Anesthetist in Rockville, MD
• Providers in Rockville, MD by specialty
• Certified Registered Nurse Anesthetist in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 16, 2018; 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.