Active NPI
Taylor Kathryn Shannon, CRNA
- Certified Registered Nurse Anesthetist
- Flagstaff, AZ
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Certified Registered Nurse Anesthetist
- License
- 319403
- Practice address
- 1200 N Beaver St
Flagstaff, AZ 86001-3118 - Phone
- (928) 779-3366
- NPI assigned
- Jul 22, 2018
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Certified Registered Nurse Anesthetist | 367500000X | RN2301626 | MA | |
| Certified Registered Nurse Anesthetist | 367500000X | 319403 | AZ | Primary |
Addresses
Primary practice location
1200 N Beaver St
Flagstaff, AZ 86001-3118
Mailing address
960 Massachusetts Avenue
FL 2
Boston, Ma 02119, MA 02118-2690
Other practice location 1
1 Boston Medical Ctr Pl
Boston, MA 02118-2908
Phone (617) 638-6950
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 110164287A | Medicaid | MA | |
| 3125777 | Medicaid | NH |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MA, AZ
Enrollment records 2
Care Compare profile
Medicare Care Compare- Specialty
- Certified Registered Nurse Anesthetist (Crna)
- Education
- Other, 2020
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1200 N Beaver St
Flagstaff, AZ 86001-3118
Phone (928) 779-3366
1215 N Beaver St
Suite 203
Flagstaff, AZ 86001-3126
Phone (928) 773-2249
2000 S Thompson St
Flagstaff, AZ 86001-8759
Phone (928) 226-6400
7810 N US Hwy 89
Flagstaff, AZ 86004-6255
Phone (928) 522-8375
Hospital & facility affiliations
- Flagstaff Medical Center
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 319403 | AZ | MD | Certified Registered Nurse Anesthetist |
| RN2301626 | MA | MD | Certified Registered Nurse Anesthetist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Northern Arizona Healthcare Corporation | Current | Accepting new patients | |
| Flagstaff Pathology Associates | Current | Accepting new patients | |
| Northern Arizona Healthcare Corporation | Current | Accepting new patients | |
| Neb Radiology PC | Past | Accepting new patients |
Locations
269 S Candy Ln
Cottonwood, AZ 86326
Phone (928) 634-2251
1200 N Beaver St
Flagstaff, AZ 86001
Phone (928) 213-6235
1215 N Beaver St
Ste 203
Flagstaff, AZ 86001
Phone (928) 773-2249
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.
-
- Family Medicine Physician
- Flagstaff, AZ
- NPI 1669914552
-
- Anatomic Pathology & Clinical Pathology Physician
- Flagstaff, AZ
- NPI 1306205612
-
- Multi-Specialty Clinic/Center
- Flagstaff, AZ
- NPI 1235732702
-
- Diagnostic Radiology Physician
- Roxbury Crossing, MA
- NPI 1073590840
Hospital & facility affiliations 4
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- Psychiatric Hospital Unit
- Flagstaff, AZ
- NPI 1649370875
-
- General Acute Care Hospital
- Flagstaff, AZ
- NPI 1780635078
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1532217600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1738713600000",
"number": "1407333552",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "960 MASSACHUSETTS AVENUE",
"address_2": "FL 2",
"city": "BOSTON, MA 02119",
"state": "MA",
"postal_code": "021182690"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1200 N BEAVER ST",
"city": "FLAGSTAFF",
"state": "AZ",
"postal_code": "860013118",
"telephone_number": "928-779-3366"
}
],
"practiceLocations": [
{
"address_1": "1 Boston Medical Ctr Pl",
"address_purpose": "LOCATION",
"city": "Boston",
"state": "MA",
"postal_code": "021182908",
"country_code": "US",
"telephone_number": "617-638-6950",
"fax_number": "617-638-6966",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "SHANNON",
"first_name": "TAYLOR",
"middle_name": "KATHRYN",
"name_prefix": "Miss",
"credential": "CRNA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-07-22",
"last_updated": "2025-02-05",
"certification_date": "2025-02-05",
"status": "A"
},
"taxonomies": [
{
"code": "367500000X",
"taxonomy_group": "",
"desc": "Nurse Anesthetist, Certified Registered",
"state": "MA",
"license": "RN2301626",
"primary": false
},
{
"code": "367500000X",
"taxonomy_group": "",
"desc": "Nurse Anesthetist, Certified Registered",
"state": "AZ",
"license": "319403",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "110164287A",
"state": "MA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "3125777",
"state": "NH"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Flagstaff, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2025; 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.