Shannon L Pecka, CRNA

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

54515 Issued in NE

Practice address

988102 Nebraska Medical Ctr
Omaha, NE 68198-8102

Phone

(402) 559-4081

Fax

(402) 559-7372

NPI assigned

May 10, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Registered Nurse

State licenses

Practice roles

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.

• Northwest Anesthesia PC

  • Anesthesiology Physician
  • Omaha, NE
  • NPI 1891803300

  Nurse Anesthetist, Certified Registered

  NPD (past)

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

{
    "created_epoch": "1147219200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1309132800000",
    "number": "1386694503",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "988102 NEBRASKA MEDICAL CTR",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681988102",
            "telephone_number": "402-559-4081",
            "fax_number": "402-559-7372"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "988102 NEBRASKA MEDICAL CTR",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681988102",
            "telephone_number": "402-559-4081",
            "fax_number": "402-559-7372"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PECKA",
        "first_name": "SHANNON",
        "middle_name": "L",
        "credential": "CRNA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-05-10",
        "last_updated": "2011-06-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "NE",
            "license": "54515",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "47078557515",
            "state": "NE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jean M. Peck, OTR/L
• Joel Peck
• Kirk Michael Peck, PT, PH.D, CSCS
• Michaela Peck, OT
• Rachel Peck, OTR
• Tiffany Peckham
• Wendy L Pecoraro, APRN
• Brittany Sue Peden
• Amy Pedersen
• Brandon Pedersen

• Certified Registered Nurse Anesthetist in Omaha, NE
• Providers in Omaha, NE by specialty
• Certified Registered Nurse Anesthetist in Nebraska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 2011; 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.