Mary Shimko, CRNA

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

APRN11002284 Issued in FL

Practice address

421 SE Alfred Markham St
Lake City, FL 32025

Phone

(386) 697-1364

Fax

(888) 370-3379

NPI assigned

Oct 6, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Registered Nurse

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

{
    "created_epoch": "1160092800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1562889600000",
    "number": "1487741096",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "421 SE ALFRED MARKHAM ST",
            "city": "LAKE CITY",
            "state": "FL",
            "postal_code": "32025",
            "telephone_number": "386-697-1364",
            "fax_number": "888-370-3379"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "421 SE ALFRED MARKHAM ST",
            "city": "LAKE CITY",
            "state": "FL",
            "postal_code": "32025",
            "telephone_number": "386-697-1364",
            "fax_number": "888-370-3379"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHIMKO",
        "first_name": "MARY",
        "name_prefix": "Miss",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-06",
        "last_updated": "2019-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "FL",
            "license": "APRN11002284",
            "primary": true
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "NC",
            "license": "191552",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PENDING",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mary Shenouda, M.D.
• Demetrius Sheppard
• Eva Sheppard
• Troy L Sheppard
• John Ronald Sherman, PTA
• Gavin D Shoal, PH.D.
• George Wiley Shorter III, PH. D.
• Jessica Shotwell, ARNP
• Taylor Sikes, MPH, RDN
• Myrna Silva

• Certified Registered Nurse Anesthetist in Lake City, FL
• Providers in Lake City, FL by specialty
• Certified Registered Nurse Anesthetist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.