Autum Shaw, CRNA

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

APRN11032916 Issued in FL

Practice address

1 Shircliff Way
Jacksonville, FL 32204-4748

Phone

(904) 308-7300

NPI assigned

May 1, 2024

Last updated

Nov 18, 2024By the provider in NPPES

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

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Specialty

Certified Registered Nurse Anesthetist (Crna)

Education

Other, 2024

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

North Florida Anesthesia Consultants IncGroup PAC ID 7416869565, 110 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Ascension St Vincent's Riverside Hospital, Jacksonville, FL, CCN 100040
• Ascension St Vincent's Southside Hospital, Jacksonville, FL, CCN 100307
• Ascension St Vincent's Clay County Hospital, Middleburg, FL, CCN 100321

Medicare enrollment (NPD)

Enrolled

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• North Florida Anesthesia Consultants Inc

  • Anesthesiology Physician
  • Jacksonville, FL
  • NPI 1346236866

  Nurse Anesthetist, Certified Registered

  Medicare reassignment Care Compare group NPD
• North Florida Anesthesia Consultants Inc

  • Anesthesiology Physician
  • Jacksonville, FL
  • NPI 1255009296

  Nurse Anesthetist, Certified Registered

  NPD
• North Florida Anesthesia Consultants, Inc.

  • Anesthesiology Physician
  • St Augustine, FL
  • NPI 1114892361
  NPD

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

• St Lukes - St Vincents Healthcare

  dba Ascension St. Vincent's Southside

  • General Acute Care Hospital
  • Jacksonville, FL
  • NPI 1396926747
  Care Compare affiliation
• St Vincents Medical Center Inc

  dba Ascension St. Vincent's Riverside

  • General Acute Care Hospital
  • Jacksonville, FL
  • NPI 1134117575
  Care Compare affiliation
• St. Vincent's Medical Center-Clay County, Inc.

  dba Ascension St. Vincent's Clay County

  • General Acute Care Hospital
  • Middleburg, FL
  • NPI 1457690471
  Care Compare affiliation
• St. Vincent's Medical Center, Inc.

  dba Ascension St Vincent's Riverside

  • Clinical Medical Laboratory
  • Jacksonville, FL
  • NPI 1669556072

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1714521600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731888000000",
    "number": "1497502207",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8501 STOCKS RD",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322201222",
            "telephone_number": "904-707-9749"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 SHIRCLIFF WAY",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322044748",
            "telephone_number": "904-308-7300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAW",
        "first_name": "AUTUM",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-05-01",
        "last_updated": "2024-11-18",
        "certification_date": "2024-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "FL",
            "license": "APRN11032916",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "FL",
            "license": "9424972",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rachel Shaw-Wilson
• Andrea B Shaw, DC
• Andreae Arey Shaw, M.D.
• Andrew Brian Shaw, M.D.
• Ashley Lynn Shaw
• Chad P Shaw, DC
• Faith Shaw
• Lindsay J Shaw, FNP-BC
• Mallory Lynn Shaw, LMSW
• Michael M Shaw, PH.D, LMHC

• Certified Registered Nurse Anesthetist in Jacksonville, FL
• Providers in Jacksonville, 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 Nov 18, 2024; 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.