Individual provider Active NPI

Jamie Sue Shahan, CRNA

  • Certified Registered Nurse Anesthetist
  • North Little Rock, AR
National Provider Identifier
1467533091
Registry record updated Aug 10, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
CO1443 CRNA Issued in AR
Practice address
5201 N Shore Dr
North Little Rock, AR 72118-5312
Phone
(501) 748-8000
Fax
(501) 748-8159
NPI assigned
Oct 18, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 10, 2023

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 CO1443 CRNA AR Primary

Addresses

Primary practice location

5201 N Shore Dr
North Little Rock, AR 72118-5312

Mailing address

4301 W Markham St # 783
Little Rock, AR 72205-7101
Phone (501) 686-8000

Other practice location 1

4301 W Markham St # 515
Little Rock, AR 72205-7101
Phone (501) 686-6114

Other identifiers 1

IdentifierTypeStateIssuer
152965701MedicaidAR

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040510000587 AR Practitioner - Certified Registered Nurse Anesthetist (Crna) 9739178369 Reassigns benefits to 8 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
University of Arkansas for Medical SciencesGroup PAC ID 4082528955, shared by 29 NPIs, 1,159 clinicians

Practice addresses (Care Compare)

4301 W Markam St
Little Rock, AR 72205-7101

Hospital & facility affiliations

  • University of Arkansas Medical Sciences Hospital, Little Rock, AR, CCN 040016

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
CO1443 CRNAARMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
BP Anesthesia, PLLC Nurse Anesthetist, Certified Registered CurrentSince Feb 1, 2019 Accepting new patients
Southern Regional Anesthesiology Consultants PLLC CurrentSince Jul 23, 2020 Accepting new patients
University of Arkansas for Medical Sciences CurrentSince Oct 15, 2018 Accepting new patients
University of Arkansas for Medical Sciences CurrentSince Oct 15, 2018 Accepting new patients
Youngs Professional Services LLC Nurse Anesthetist, Certified Registered CurrentSince Oct 1, 2022 Accepting new patients
NLR Gi Anesthesia, LLC Nurse Anesthetist, Certified Registered CurrentSince Aug 2, 2021 Accepting new patients
St. Vincent Medical Group CurrentSince Nov 1, 2024 Accepting new patients
University of Arkansas for Medical Sciences CurrentSince Oct 15, 2018 Accepting new patients
Arkansas Childrens Hospital Past Accepting new patients
Conway Anesthesiology Consultants, P.a. PastSince Mar 1, 2020 Accepting new patients
Endoscopy Center of Arkansas Anesthesia, LLC Nurse Anesthetist, Certified Registered Past Accepting new patients

Locations

700 W Grove St
El Dorado, AR 71730
Phone (870) 863-2200

1001 Towson Ave
Fort Smith, AR 72901
Phone (479) 441-3980

3320 Central Ave
Hot Springs, AR 71913
Phone (501) 321-0560

300 Werner St
Hot Springs National Park, AR 71913
Phone (501) 622-1000

1811 Rahling Rd
Ste 120
Little Rock, AR 72223
Phone (501) 214-2360

4301 W Markham St
Little Rock, AR 72205
Phone (501) 603-1278

4301 W Markham St
#783
Little Rock, AR 72205
Phone (501) 603-1278

1 Childrens Way
#653
Little Rock, AR 72202
Phone (501) 614-2006

4301 W Markham St
#515
Little Rock, AR 72205
Phone (501) 603-1656

7 Shackleford West Blvd
Little Rock, AR 72211
Phone (501) 614-3671

16221 Saint Vincent Way
Little Rock, AR 72223
Phone (501) 221-0888

9601 Interstate 630
Little Rock, AR 72205
Phone (501) 202-2300

500 S University Ave
Ste 500
Little Rock, AR 72205
Phone (501) 320-1101

100 N Fillmore St
Little Rock, AR 72205
Phone (870) 226-5875

2 Saint Vincent Cir
Little Rock, AR 72205
Phone (501) 552-2680

4 Hospital Dr
Morrilton, AR 72110
Phone (501) 977-2300

3401 Springhill Dr
Ste 155
North Little Rock, AR 72117
Phone (501) 202-3631

2209 Wildwood Ave
Sherwood, AR 72120
Phone (501) 834-5777

Organizations & group practices 12

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": "1161129600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691625600000",
    "number": "1467533091",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4301 W MARKHAM ST # 783",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722057101",
            "telephone_number": "501-686-8000",
            "fax_number": "501-526-5148"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5201 N SHORE DR",
            "city": "NORTH LITTLE ROCK",
            "state": "AR",
            "postal_code": "721185312",
            "telephone_number": "501-748-8000",
            "fax_number": "501-748-8159"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4301 W Markham St # 515",
            "address_purpose": "LOCATION",
            "city": "Little Rock",
            "state": "AR",
            "postal_code": "722057101",
            "country_code": "US",
            "telephone_number": "501-686-6114",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHAHAN",
        "first_name": "JAMIE",
        "middle_name": "SUE",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-18",
        "last_updated": "2023-08-10",
        "certification_date": "2023-08-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "AR",
            "license": "CO1443 CRNA",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "152965701",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in North Little Rock, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 2023; 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.