Nicole Genevieve Shadwick, CRNA

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

1026890 Issued in TX

Practice address

101 Civic Center LN
Lake Havasu City, AZ 86403-5607

Phone

(928) 855-8185

Fax

(928) 453-0453

NPI assigned

Oct 2, 2020

Sex

Female

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in TX, FL, CA, AZ4 enrollments

Enrollment records 4

Specialty

Certified Registered Nurse Anesthetist (Crna)

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Valley Regional Anesthesia Associates IncGroup PAC ID 3870964323, 143 clinicians

U S Anesthesia Partners of Texas, PAGroup PAC ID 7315850351, 2,750 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Doctors Medical Center Hospital, Modesto, CA, CCN 050464
• Texas Health Arlington Memorial Hospital Hospital, Arlington, TX, CCN 450064

Merit-based Incentive Payment System (MIPS)

Final score

63.03 of 100Reported as group

Quality

44.74

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Registered Nurse

State licenses

Practice roles

Locations (25 of 37)

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.

• U. S. Anesthesia Partners of Texas, P.a.,

  dba Greater Houston Anesthesiology, P.A.

  • Anesthesiology Physician
  • Houston, TX
  • NPI 1548208564

  Nurse Anesthetist, Certified Registered

  Medicare reassignment Care Compare group NPD
• Valley Regional Anesthesia Associates Inc

  • Anesthesiology Physician
  • Fresno, CA
  • NPI 1578272415

  AZ, TX

  Medicare reassignment Care Compare group NPD
• Northeastern Anesthesia PLLC

  • Anesthesiology Physician
  • Sierra Vista, AZ
  • NPI 1487956504

  Nurse Anesthetist, Certified Registered

  Medicare reassignment NPD
• Anesthesia Dynamics LLC

  • Anesthesiology Physician
  • Bradenton, FL
  • NPI 1073001012

  Nurse Anesthetist, Certified Registered

  Medicare reassignment NPD
• Austin Anesthesiology Group, PLLC

  • Anesthesiology Physician
  • Austin, TX
  • NPI 1598724304

  Nurse Anesthetist, Certified Registered

  Medicare reassignment NPD
• FDHS Anesthesia LLC

  • Certified Registered Nurse Anesthetist
  • Bradenton, FL
  • NPI 1619571361

  Nurse Anesthetist, Certified Registered

  Medicare reassignment NPD
• Gulf-to-Bay Anesthesiology Associates LLC

  • Anesthesiology Physician
  • Tampa, FL
  • NPI 1720039746
  Medicare reassignment NPD
• Northstar Anesthesia II PA

  • Anesthesiology Physician
  • Burleson, TX
  • NPI 1477066405

  Nurse Anesthetist, Certified Registered

  Medicare reassignment NPD
• Northstar Anesthesia III PA

  • Anesthesiology Physician
  • Corpus Christi, TX
  • NPI 1356968952

  Nurse Anesthetist, Certified Registered

  Medicare reassignment NPD
• Northstar Anesthesia, PA

  • Anesthesiology Physician
  • Arlington, TX
  • NPI 1912978610

  Nurse Anesthetist, Certified Registered

  Medicare reassignment NPD
• Austin Anesthesiology Group PLLC

  • Anesthesiology Physician
  • Bryan, TX
  • NPI 1528326154
  NPD
• Gulf-to-Bay Anesthesiology Associates LLC

  • Anesthesiology Physician
  • Largo, FL
  • NPI 1316205339
  NPD

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

• Doctors Medical Center of Modesto, Inc.

  dba Doctors Medical Center of Modesto

  • General Acute Care Hospital
  • Modesto, CA
  • NPI 1184654923
  Care Compare affiliation
• Texas Health Arlington Memorial Hospital

  • General Acute Care Hospital
  • Arlington, TX
  • NPI 1174533343
  Care Compare affiliation

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

{
    "created_epoch": "1601596800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757289600000",
    "number": "1447857552",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "660 S EUCLID AVE",
            "address_2": "CB 8054",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631101010",
            "telephone_number": "800-862-9980",
            "fax_number": "314-362-1185"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 CIVIC CENTER LN",
            "city": "LAKE HAVASU CITY",
            "state": "AZ",
            "postal_code": "864035607",
            "telephone_number": "928-855-8185",
            "fax_number": "928-453-0453"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1 Barnes Jewish Hospital Plz",
            "address_2": "Dept Anesthesiology",
            "address_purpose": "LOCATION",
            "city": "Saint Louis",
            "state": "MO",
            "postal_code": "631101003",
            "country_code": "US",
            "telephone_number": "800-862-9980",
            "fax_number": "314-362-1185",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHADWICK",
        "first_name": "NICOLE",
        "middle_name": "GENEVIEVE",
        "name_prefix": "Ms.",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-10-02",
        "last_updated": "2025-09-08",
        "certification_date": "2025-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "CA",
            "license": "95002021",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "FL",
            "license": "APRN11022686",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MO",
            "license": "2022021771",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "TX",
            "license": "1026890",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "910112970",
            "state": "MO"
        }
    ],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/",
            "affiliation": "Y",
            "affiliationName": "Washington University",
            "address_1": "1 Barnes Jewish Hospital Plz",
            "address_2": "Dept Anesthesiology",
            "city": "Saint Louis",
            "state": "MO",
            "country_code": "US",
            "postal_code": "631101003",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Certified Registered Nurse Anesthetist in Lake Havasu City, AZ
• Providers in Lake Havasu City, AZ by specialty
• Certified Registered Nurse Anesthetist in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 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.

Verify at the official NPI Registry.