Individual provider Active NPI

Ladd Shaner, C.R.N.A.

  • Certified Registered Nurse Anesthetist
  • Burns, OR
National Provider Identifier
1497747745
Registry record updated Nov 19, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
201805701CRNA-PP Issued in OR
Practice address
557 W Washington St
Burns, OR 97720
Phone
(541) 573-7281
NPI assigned
Aug 22, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 19, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X APRN.CRNA.02531 OH
Certified Registered Nurse Anesthetist 367500000X 201805701CRNA-PP OR Primary

Addresses

Primary practice location

557 W Washington St
Burns, OR 97720

Mailing address

8766 Galloway TRL
Novelty, OH 44072-9653
Phone (440) 338-6955

Other identifiers 1

IdentifierTypeStateIssuer
0869163MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
APRN.CRNA.02531OHMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Queen City Anesthesiologists Inc Past Accepting new patients
Grant Anesthesia Services LTD Past Accepting new patients
Anesthesia Associates of Mansfield, Inc PastSince Jan 15, 2004 Accepting new patients
Millenium Anesthesia LLC Past Accepting new patients

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1124668800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1542585600000",
    "number": "1497747745",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8766 GALLOWAY TRL",
            "city": "NOVELTY",
            "state": "OH",
            "postal_code": "440729653",
            "telephone_number": "440-338-6955"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "557 W WASHINGTON ST",
            "city": "BURNS",
            "state": "OR",
            "postal_code": "97720",
            "telephone_number": "541-573-7281"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHANER",
        "first_name": "LADD",
        "name_prefix": "Mr.",
        "credential": "C.R.N.A.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-22",
        "last_updated": "2018-11-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "OH",
            "license": "APRN.CRNA.02531",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "OR",
            "license": "201805701CRNA-PP",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0869163",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Burns, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 2018; 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.