Individual provider Active NPI

Silas Shane McFall, CRNA

  • Certified Registered Nurse Anesthetist
  • Hazard, KY
National Provider Identifier
1407187644
Registry record updated Nov 2, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
21707 Issued in TN
Practice address
100 Medical Center Dr
Hazard, KY 41701-9421
Phone
(606) 439-6600
NPI assigned
Jan 28, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 2, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 3006351 KY
Certified Registered Nurse Anesthetist 367500000X 21707 TN Primary

Addresses

Primary practice location

100 Medical Center Dr
Hazard, KY 41701-9421

Mailing address

100 Medical Center Dr
Hazard, KY 41701-9421
Phone (606) 439-6600

Other identifiers 1

IdentifierTypeStateIssuer
7100103470MedicaidKY

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20151204002101 MS Practitioner - Certified Registered Nurse Anesthetist (Crna) 2264577253 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Perioperative Services of Mississippi, LLCGroup PAC ID 8921365255, 98 clinicians

Practice addresses (Care Compare)

1225 N State St
Ms Baptist Medical Center
Jackson, MS 39202-2064
Phone (601) 317-2802

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Jackson Anesthesia Associates PA CurrentSince May 1, 2017 Accepting new patients
Northstar Anesthesia of Mississippi, LLC Nurse Anesthetist, Certified Registered CurrentSince Oct 21, 2015 Accepting new patients
Perioperative Services of Mississippi, LLC CurrentSince Jun 2, 2023 Accepting new patients
Jackson Pain Center PA Past Accepting new patients
Triangle Anesthesia Group PSC Nurse Anesthetist, Certified Registered Past Accepting new patients

Locations

350 Crossgates Blvd
Brandon, MS 39042
Phone (601) 824-8500

1053 River Oaks Dr
#C
Flowood, MS 39232
Phone (601) 969-1430

1225 N State St
Jackson, MS 39202
Phone (601) 292-4261

1151 N State St
Ste 311
Jackson, MS 39202
Phone (601) 969-1171

2100 Highway 61 N
Vicksburg, MS 39183
Phone (601) 883-5001

Organizations & group practices 5

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": "1264636800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1478044800000",
    "number": "1407187644",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 MEDICAL CENTER DR",
            "city": "HAZARD",
            "state": "KY",
            "postal_code": "417019421",
            "telephone_number": "606-439-6600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 MEDICAL CENTER DR",
            "city": "HAZARD",
            "state": "KY",
            "postal_code": "417019421",
            "telephone_number": "606-439-6600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCFALL",
        "first_name": "SILAS",
        "middle_name": "SHANE",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-01-28",
        "last_updated": "2016-11-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "KY",
            "license": "3006351",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "TN",
            "license": "21707",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100103470",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hazard, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2016; 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.