Shannon Lacey Staten, CRNA

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

RN188967 Issued in GA

Practice address

1 Meadows Pkwy
Vidalia, GA 30474-8759

Phone

(912) 538-5537

NPI assigned

Feb 2, 2012

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

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

Specialty

Certified Registered Nurse Anesthetist (Crna)

Education

Other, 2011

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

SE Georgia Anesthesia, LLCGroup PAC ID 8426466137, 114 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Memorial Health Meadows Hospital Hospital, Vidalia, GA, CCN 110128

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Registered Nurse

State licenses

Practice roles

Locations

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.

• SE Georgia Anesthesia, LLC

  dba Memorial Health Meadows Physicians- Anesthesia

  • Anesthesiology Physician
  • Vidalia, GA
  • NPI 1518542919

  Nurse Anesthetist, Certified Registered

  Medicare reassignment Care Compare group NPD

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

• Vidalia Health Services, LLC

  • General Acute Care Hospital
  • Vidalia, GA
  • NPI 1790376564
  Care Compare affiliation

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

{
    "created_epoch": "1328140800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1440633600000",
    "number": "1437421773",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1303",
            "city": "VIDALIA",
            "state": "GA",
            "postal_code": "304751303",
            "telephone_number": "912-538-5537",
            "fax_number": "912-538-5228"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 MEADOWS PKWY",
            "city": "VIDALIA",
            "state": "GA",
            "postal_code": "304748759",
            "telephone_number": "912-538-5537"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STATEN",
        "first_name": "SHANNON",
        "middle_name": "LACEY",
        "credential": "CRNA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-02-02",
        "last_updated": "2015-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "GA",
            "license": "RN188967",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Carl Leland Stalvey, M.D.
• Kristin Nicole Stanford, PHARMD
• Leann Davis Stanley, M.ED.CCCSLP
• Nancy W Stanley, DPT
• Matthew Jared Staples, MD
• Steven P Hill, MD,PC
• Gillian Josephine Stuart, M.D.
• Hubert McCrary Suber, MD
• Sundance Rehabilitation
• Sweet Onion Pharmacy

• Certified Registered Nurse Anesthetist in Vidalia, GA
• Providers in Vidalia, GA by specialty
• Certified Registered Nurse Anesthetist in Georgia

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