Individual provider Active NPI

Shane D Garner, CRNA

  • Certified Registered Nurse Anesthetist
  • Ripon, WI
National Provider Identifier
1457612640
Registry record updated Apr 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
171073030 Issued in WI
Practice address
846 Windsor Rd
Ripon, WI 54971-2608
Phone
(262) 352-4521
NPI assigned
Jun 4, 2012
Last updated
Apr 10, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 10, 2025

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 171073030 WI Primary

Addresses

Primary practice location

846 Windsor Rd
Ripon, WI 54971-2608

Mailing address

846 Windsor Rd
Ripon, WI 54971-2608
Phone (262) 352-4521

Other practice location 1

845 Parkside St
Ripon, WI 54971-8505
Phone (920) 748-3101

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address sgarner332242@direct-ehr-ssmhc.com Direct
FHIR URL https://fhir.ssmhc.com/fhir/api/FHIR/DSTU2/ Other

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20121011000912 WI Practitioner - Certified Registered Nurse Anesthetist (Crna) 9133378839 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Divine Savior Healthcare IncGroup PAC ID 5799684007, 135 clinicians
Agnesian Healthcare IncGroup PAC ID 1658289624, 392 clinicians
Anesthesia Services of the Fox Valley SCGroup PAC ID 1658345228, 16 clinicians

Practice addresses (Care Compare)

2817 New Pinery Rd
Portage, WI 53901-9240
Phone (608) 742-4131

360 S Mountin Dr
Mayville, WI 53050-1498
Phone (920) 387-2111

420 E Division St
Fond Du Lac, WI 54935-4560
Phone (920) 923-7400

430 E Division St
Fond Du Lac, WI 54935-4560
Phone (920) 929-2300

4648 W Spencer St
Appleton, WI 54914-9106
Phone (920) 731-7557

608 W Brown St
Waupun, WI 53963-1702
Phone (920) 324-6800

620 W Brown St
Waupun, WI 53963-1702
Phone (920) 324-6531

835 Parkside St
Ripon, WI 54971-8505
Phone (920) 748-3101

845 Parkside St
Ripon, WI 54971-8505
Phone (920) 748-3101

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
171073030WIMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Garner Anesthesia Services LLC Nurse Anesthetist, Certified Registered CurrentSince Nov 1, 2014 Accepting new patients
Agnesian Healthcare, Inc Current Accepting new patients
Agnesian Healthcare Inc CurrentSince Aug 26, 2019 Accepting new patients
Agnesian Healthcare Inc CurrentSince Aug 26, 2019 Accepting new patients
Thedacare Medical Center - Berlin, Inc. Past Accepting new patients

Locations

225 Memorial Dr
Berlin, WI 54923
Phone (920) 361-1313

420 E Division St
Fond du Lac, WI 54935
Phone (920) 923-7400

277 N Altenhofen Dr
Grand Chute, WI 54913
Phone (920) 212-3609

360 S Mountin Dr
Mayville, WI 53050
Phone (920) 387-2111

501 Doctors Ct
Oshkosh, WI 54901
Phone (608) 829-7777

845 Parkside St
Ripon, WI 54971
Phone (920) 748-3101

933 Newbury St
Ripon, WI 54971
Phone (920) 748-0430

620 W Brown St
Waupun, WI 53963
Phone (920) 324-5581

Interoperability endpoints

  • Direct secure messaging: sgarner332242@direct-ehr-ssmhc.com

Organizations & group practices 7

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 3

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": "1338768000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744243200000",
    "number": "1457612640",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "846 WINDSOR RD",
            "city": "RIPON",
            "state": "WI",
            "postal_code": "549712608",
            "telephone_number": "262-352-4521"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "846 WINDSOR RD",
            "city": "RIPON",
            "state": "WI",
            "postal_code": "549712608",
            "telephone_number": "262-352-4521"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "845 Parkside St",
            "address_purpose": "LOCATION",
            "city": "Ripon",
            "state": "WI",
            "postal_code": "549718505",
            "country_code": "US",
            "telephone_number": "920-748-3101",
            "fax_number": "920-926-8370",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GARNER",
        "first_name": "SHANE",
        "middle_name": "D",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-06-04",
        "last_updated": "2025-04-10",
        "certification_date": "2025-04-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "WI",
            "license": "171073030",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "sgarner332242@direct-ehr-ssmhc.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "sgarner332242@direct-ehr-ssmhc.com",
            "address_1": "845 Parkside St",
            "city": "Ripon",
            "state": "WI",
            "country_code": "US",
            "postal_code": "549718505",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://fhir.ssmhc.com/fhir/api/FHIR/DSTU2/",
            "affiliation": "N",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "FHIR API",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCD",
            "address_1": "845 Parkside St",
            "city": "Ripon",
            "state": "WI",
            "country_code": "US",
            "postal_code": "549718505",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Ripon, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 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.