Shannon M Kidd, CRNA

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

COA.11504.NA Issued in OH

Practice address

401 Matthew St
Marietta, OH 45750-1635

Phone

(740) 374-9990

Fax

(740) 374-9993

NPI assigned

Nov 29, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 5

Other names 1

• Shannon M Jenkins Former name

Medicare fee-for-service enrollment

Enrolled in WV, OH, PA3 enrollments

Enrollment records 3

Specialty

Certified Registered Nurse Anesthetist (Crna)

Education

Other, 2007

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

PHS Anesthesia Billing, LLCGroup PAC ID 2264958412, 241 clinicians

Sandusky Anesthesia LLCGroup PAC ID 3274895271, 117 clinicians

Anesthesia Management Associates LLCGroup PAC ID 3577902808, 16 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Miami Valley Hospital Hospital, Dayton, OH, CCN 360051
• Kettering Health Main Campus Hospital, Kettering, OH, CCN 360079

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Registered Nurse

State licenses

Practice roles

Locations (25 of 29)

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.

• Anesthesia Management Associates LLC

  • Anesthesiology Physician
  • Marysville, OH
  • NPI 1891566071
  Medicare reassignment Care Compare group NPD
• PHS Anesthesia Billing, LLC

  • Anesthesiology Physician
  • Middletown, OH
  • NPI 1578361044
  Medicare reassignment Care Compare group NPD
• Sandusky Anesthesia LLC

  • Certified Registered Nurse Anesthetist
  • Circleville, OH
  • NPI 1770907859

  Nurse Anesthetist, Certified Registered

  Medicare reassignment Care Compare group NPD
• Anesthesia Associates of Cincinnati, Inc

  • Anesthesiology Physician
  • Cincinnati, OH
  • NPI 1316945173

  Nurse Anesthetist, Certified Registered

  Medicare reassignment NPD
• Buckeye Anesthesia Associates

  • Anesthesiology Physician
  • London, OH
  • NPI 1124641022
  Medicare reassignment NPD
• Cgi Anesthesia Associates LLC

  • Certified Registered Nurse Anesthetist
  • Cincinnati, OH
  • NPI 1174914352

  Nurse Anesthetist, Certified Registered

  Medicare reassignment NPD
• Columbus One Anesthesia LLC

  • Gastroenterology Physician
  • Hilliard, OH
  • NPI 1528560646
  Medicare reassignment NPD
• Dayton Anesthesia & Pain Services, LLC

  • Anesthesiology Physician
  • Dayton, OH
  • NPI 1629401898

  Nurse Anesthetist, Certified Registered

  Medicare reassignment NPD
• Ogi Anesthesia, LLC

  • Certified Registered Nurse Anesthetist
  • Cincinnati, OH
  • NPI 1962776807

  Nurse Anesthetist, Certified Registered

  Medicare reassignment NPD
• 360 Anesthesia PLLC

  • Anesthesiology Physician
  • Wilkes Barre, PA
  • NPI 1811637366

  Nurse Anesthetist, Certified Registered

  Medicare reassignment NPD
• Anesthesia Dynamics LLC

  • Anesthesiology Physician
  • Bradenton, FL
  • NPI 1073001012

  Nurse Anesthetist, Certified Registered, OH

  Medicare reassignment NPD
• Cabell Huntington Hospital Inc

  • Anesthesiology Physician
  • Huntington, WV
  • NPI 1275576373

  Nurse Anesthetist, Certified Registered

  Medicare reassignment NPD

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

• Kettering Medical Center

  • General Acute Care Hospital
  • Kettering, OH
  • NPI 1043233984
  Care Compare affiliation
• Miami Valley Hospital

  • General Acute Care Hospital
  • Dayton, OH
  • NPI 1073688354
  Care Compare affiliation

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

{
    "created_epoch": "1196294400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1488758400000",
    "number": "1508048737",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2139 AUBURN AVE",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452192906",
            "telephone_number": "740-374-4500",
            "fax_number": "740-374-5887"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 MATTHEW ST",
            "city": "MARIETTA",
            "state": "OH",
            "postal_code": "457501635",
            "telephone_number": "740-374-9990",
            "fax_number": "740-374-9993"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIDD",
        "first_name": "SHANNON",
        "middle_name": "M",
        "credential": "CRNA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-11-29",
        "last_updated": "2017-03-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "WV",
            "license": "60137",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "OH",
            "license": "COA.11504.NA",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2937764",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000666683",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000662146",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3810014829",
            "state": "WV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P01058722",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SHANNON",
            "last_name": "JENKINS",
            "middle_name": "M",
            "credential": "CRNA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Kayla Kendall, LMT
• Margaret Ann Kennedy-Dygas, SLP
• Billie Kennedy, NP
• Richard Kwasi Agbeko Kessey, MD
• Aneeta R Khanna, M.D.
• Alisha Jasmine Kilmer, LPN
• Calvin Wayne Kirby
• Jordan Kirkland, DPT
• Donald Raymond Kiser, D.O.
• Sharon Klein, QMHS

• Certified Registered Nurse Anesthetist in Marietta, OH
• Providers in Marietta, OH by specialty
• Certified Registered Nurse Anesthetist in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 2017; 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.