Individual provider Active NPI

Shelly Doub Schaad, CRNA

  • Certified Registered Nurse Anesthetist
  • Raleigh, NC
National Provider Identifier
1376611327
Registry record updated Apr 3, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
74003 Issued in NC
Practice address
3000 New Bern Ave
Raleigh, NC 27610-1231
Phone
(919) 350-5645
NPI assigned
Nov 30, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 3, 2015

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 74003 NC Primary

Addresses

Primary practice location

3000 New Bern Ave
Raleigh, NC 27610-1231

Mailing address

3100 Spring Forest Rd
Suite 130
Raleigh, NC 27616-2880
Phone (919) 873-9533

Other identifiers 2

IdentifierTypeStateIssuer
8052352MedicaidNC
P00298076OtherNCRAILROAD-MEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20051028000441 NC Practitioner - Certified Registered Nurse Anesthetist (Crna) 5597782557 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Providence Anesthesiology Associates PAGroup PAC ID 3971566761, 218 clinicians
American Anesthesiology of North Carolina PLLCGroup PAC ID 2961316450, 315 clinicians

Practice addresses (Care Compare)

1918 Randolph Rd
Suite 740
Charlotte, NC 28207-1167
Phone (704) 316-0810

3000 New Bern Ave
Raleigh, NC 27610-1231
Phone (919) 873-9533

Hospital & facility affiliations

  • North Carolina Specialty Hospital Hospital, Durham, NC, CCN 340049

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
74003NCMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
American Anesthesiology of North Carolina, PLLC CurrentSince Sep 26, 2005 Accepting new patients
Providence Anesthesiology Associates, P.a. CurrentSince Dec 15, 2024 Accepting new patients
Regional Anesthesia, PLLC CurrentSince Nov 11, 2019 Accepting new patients
American Anesthesiology of North Carolina, PLLC Nurse Anesthetist, Certified Registered CurrentSince Sep 26, 2005 Accepting new patients

Locations

1900 Kildaire Farm Rd
Cary, NC 27518
Phone (919) 350-2300

1918 Randolph Rd
Ste 740
Charlotte, NC 28207
Phone (704) 316-0810

131 Providence Rd
Ste 200
Charlotte, NC 28207
Phone 70474958001101

3643 N Roxboro St
Durham, NC 27704
Phone (919) 470-6186

3100 Spring Forest Rd
Ste 130
Raleigh, NC 27616
Phone (919) 882-0705

23 Sunnybrook Rd
Ste 100
Raleigh, NC 27610
Phone (919) 322-4800

3000 New Bern Ave
Raleigh, NC 27610
Phone (919) 350-7000

3001 Edwards Mill Rd
#100
Raleigh, NC 27612
Phone (919) 719-3070

4420 Lake Boone Trl
Raleigh, NC 27607
Phone (919) 784-3034

Organizations & group practices 4

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 1

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": "1164844800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1428019200000",
    "number": "1376611327",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3100 SPRING FOREST RD",
            "address_2": "SUITE 130",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276162880",
            "telephone_number": "919-873-9533"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3000 NEW BERN AVE",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276101231",
            "telephone_number": "919-350-5645"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHAAD",
        "first_name": "SHELLY",
        "middle_name": "DOUB",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-30",
        "last_updated": "2015-04-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "NC",
            "license": "74003",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8052352",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD-MEDICARE",
            "identifier": "P00298076",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Raleigh, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 2015; 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.