Individual provider Active NPI

Shayla Willmott, CRNA

  • Certified Registered Nurse Anesthetist
  • Athens, TX
National Provider Identifier
1508288689
Registry record updated Apr 23, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
771205 Issued in TX
Practice address
510 E Clinton Ave
Athens, TX 75751-3410
Phone
(903) 677-1000
Fax
(903) 677-1694
NPI assigned
Jan 9, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 23, 2015

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 771205 TX Primary

Addresses

Primary practice location

510 E Clinton Ave
Athens, TX 75751-3410

Mailing address

510 E Clinton Ave
Athens, TX 75751-3410
Phone (903) 677-1000

Other names 1

  • Shayla Hudson Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140204001665 TX Practitioner - Certified Registered Nurse Anesthetist (Crna) 4486883832 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Emergenchealth PLLCGroup PAC ID 1355606641, 1,037 clinicians

Practice addresses (Care Compare)

2900 S Loop
256 Palestine Regional Med Ctr
Palestine, TX 75801-6958
Phone (903) 731-1147

7400 Barlite Blvd
San Antonio, TX 78224-1308
Phone (210) 921-2000

Hospital & facility affiliations

  • Palestine Regional Medical Center Hospital, Palestine, TX, CCN 450747

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
771205TXMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Emergenchealth PLLC Nurse Anesthetist, Certified Registered CurrentSince Nov 29, 2021 Accepting new patients
Youngs Professional Services LLC Nurse Anesthetist, Certified Registered CurrentSince Jul 10, 2021 Accepting new patients
Anderson County Anesthesia Associates, PA Past Accepting new patients
Apex Anesthesia Consultants, PLLC Past Accepting new patients

Locations

2900 S Loop 256
Palestine, TX 75801
Phone (903) 731-1021

7400 Barlite Blvd
San Antonio, TX 78224
Phone (210) 921-2000

1305 Wonder World Dr
Ste 105
San Marcos, TX 78666
Phone (512) 353-8161

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.

Hospital & facility affiliations 2

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": "1389225600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1429747200000",
    "number": "1508288689",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "510 E CLINTON AVE",
            "city": "ATHENS",
            "state": "TX",
            "postal_code": "757513410",
            "telephone_number": "903-677-1000",
            "fax_number": "903-677-1694"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "510 E CLINTON AVE",
            "city": "ATHENS",
            "state": "TX",
            "postal_code": "757513410",
            "telephone_number": "903-677-1000",
            "fax_number": "903-677-1694"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLMOTT",
        "first_name": "SHAYLA",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-01-09",
        "last_updated": "2015-04-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "TX",
            "license": "771205",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SHAYLA",
            "last_name": "HUDSON",
            "credential": "CRNA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Athens, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 2015; 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.