Active NPI
Lisa J Shackelford, CRNA
- Certified Registered Nurse Anesthetist
- Jonesboro, AR
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Certified Registered Nurse Anesthetist
- License
- CTP-000011
- Practice address
- 3024 Stadium Blvd
Jonesboro, AR 72401-7415 - Phone
- (501) 227-0700
- Fax
- (501) 227-0744
- NPI assigned
- Aug 1, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Certified Registered Nurse Anesthetist | 367500000X | CTP-000011 | AR | Primary |
Addresses
Primary practice location
3024 Stadium Blvd
Jonesboro, AR 72401-7415
Mailing address
304 County Road 388
Jonesboro, AR 72401-0184
Phone (870) 972-5478
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in AR
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Certified Registered Nurse Anesthetist (Crna)
- Education
- Other, 2006
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
4800 E Johnson Ave
Jonesboro, AR 72405-8413
Phone (870) 936-1000
Hospital & facility affiliations
- Baptist Memorial Hospital Jonesboro, Inc.
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Certified Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| CTP-000011 | AR | MD | Certified Registered Nurse Anesthetist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Arkansas Methodist Hospital Corporation | Current | Accepting new patients | |
| Arkansas Methodist Hospital Corporation | Current | Accepting new patients | |
| Wake Up Satisfied PA | Nurse Anesthetist, Certified Registered | Current | Accepting new patients |
| Arkansas Anesthesia Associates, PLLC. | Current | Accepting new patients | |
| Lifelinc Anesthesia V, P.a. | Nurse Anesthetist, Certified Registered | Current | Accepting new patients |
Locations
2241 Hill Park Cv
#B
Jonesboro, AR 72401
Phone (870) 333-5747
4800 E Johnson Ave
Jonesboro, AR 72405
Phone (870) 732-2100
10301 Kanis Rd
Little Rock, AR 72205
Phone (501) 604-4151
624 Hospital Dr
#4610
Mountain Home, AR 72653
Phone (870) 508-1810
900 W Kingshighway
Paragould, AR 72450
Phone (870) 239-7000
209 S Main St
Poplar Bluff, MO 63901
3340 Players Club Pkwy
Ste 350
Memphis, TN 38125
Phone (901) 207-2017
Organizations & group practices 6
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.
-
- Anesthesiology Physician
- West Memphis, AR
- NPI 1063907244
Nurse Anesthetist, Certified Registered
-
- Anesthesiology Physician
- Benton, AR
- NPI 1497023360
-
- Anesthesiology Physician
- Paragould, AR
- NPI 1861593816
-
- Certified Registered Nurse Anesthetist
- Jonesboro, AR
- NPI 1093237182
Nurse Anesthetist, Certified Registered
-
- Anesthesiology Physician
- Mountain Home, AR
- NPI 1114178753
-
- Otolaryngology Physician
- Paragould, AR
- NPI 1205457405
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Jonesboro, AR
- NPI 1386699353
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1154390400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1528074374",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "304 COUNTY ROAD 388",
"city": "JONESBORO",
"state": "AR",
"postal_code": "724010184",
"telephone_number": "870-972-5478"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3024 STADIUM BLVD",
"city": "JONESBORO",
"state": "AR",
"postal_code": "724017415",
"telephone_number": "501-227-0700",
"fax_number": "501-227-0744"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHACKELFORD",
"first_name": "LISA",
"middle_name": "J",
"credential": "CRNA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-08-01",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "367500000X",
"taxonomy_group": "",
"desc": "Nurse Anesthetist, Certified Registered",
"state": "AR",
"license": "CTP-000011",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Jonesboro, AR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.