NPIMap

Individual provider Active NPI

Jill Marie Shaw

  • Certified Registered Nurse Anesthetist
  • Louisville, KY
National Provider Identifier
1396332706
Registry record updated May 6, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
131675 Issued in KY
Practice address
200 E Chestnut St
Louisville, KY 40202-1831
Phone
(502) 939-1736
NPI assigned
Dec 31, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 6, 2021

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 131675 KY Primary

Addresses

Primary practice location

200 E Chestnut St
Louisville, KY 40202-1831

Mailing address

6225 State Hwy 161 Ste 200
Irving, TX 75038-2241

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210611000944 KY Practitioner - Certified Registered Nurse Anesthetist (Crna) 0749680882 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
University of Cincinnati College of Medicine, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Professional Anesthesia Services of Kentucky PLLCGroup PAC ID 0244590305, 351 clinicians

Practice addresses (Care Compare)

200 E Chestnut St
Louisville, KY 40202-1831
Phone (502) 629-8000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
131675KYMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Professional Anesthesia Services of Kentucky PLLC Nurse Anesthetist, Certified Registered CurrentSince Apr 8, 2021 Accepting new patients

Locations

913 N Dixie Ave
Elizabethtown, KY 42701
Phone (270) 706-1212

200 E Chestnut St
Louisville, KY 40202
Phone (502) 446-8000

4960 Norton Healthcare Blvd
Louisville, KY 40241
Phone (502) 446-8000

6225 State Highway 161
Ste 200
Irving, TX 75038
Phone (214) 687-0496

Organizations & group practices 1

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 14

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1609372800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620259200000",
    "number": "1396332706",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6225 STATE HWY 161 STE 200",
            "city": "IRVING",
            "state": "TX",
            "postal_code": "750382241"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 E CHESTNUT ST",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402021831",
            "telephone_number": "502-939-1736"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAW",
        "first_name": "JILL",
        "middle_name": "MARIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-12-31",
        "last_updated": "2021-05-06",
        "certification_date": "2021-05-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "KY",
            "license": "131675",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Louisville, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 2021; 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.