Active NPI
Kellie T Shanholtz, CRNA
- Certified Registered Nurse Anesthetist
- Winchester, VA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Certified Registered Nurse Anesthetist
- License
- AC002767
- Practice address
- 1840 Amherst St
Winchester, VA 22601-2808 - Phone
- (540) 536-8000
- Fax
- (540) 536-7681
- NPI assigned
- Feb 28, 2006
- Last updated
- Jul 17, 2019
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Certified Registered Nurse Anesthetist | 367500000X | AC002767 | MD | Primary |
| Certified Registered Nurse Anesthetist | 367500000X | 0024134809 | VA |
Addresses
Primary practice location
1840 Amherst St
Winchester, VA 22601-2808
Mailing address
1840 Amherst St
Winchester, VA 22601-2808
Phone (540) 536-8000
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2604151000 | Medicaid | WV |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in VA, MD, WV, DC
Enrollment records 4
Care Compare profile
Medicare Care Compare- Specialty
- Certified Registered Nurse Anesthetist (Crna)
- Education
- Other, 1997
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
2500 Hospital Dr
Martinsburg, WV 25401-3402
Phone (304) 260-1443
Hospital & facility affiliations
Merit-based Incentive Payment System (MIPS)
- Final score
- 95.34 of 100
- Quality
- 79.86
- Promoting interoperability
- 100
- Improvement activities
- 40
Merit-based Incentive Payment System (MIPS)
- Final score
- 95.34 of 100
- Quality
- 79.86
- Promoting interoperability
- 100
- Improvement activities
- 40
Merit-based Incentive Payment System (MIPS)
- Final score
- 63.85 of 100
- Quality
- 57.47
- Improvement activities
- 40
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Certified Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0024134809 | VA | MD | Certified Registered Nurse Anesthetist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Winchester Medical Center | Current | Accepting new patients | |
| American Anesthesiology of Virginia, PC | Current | Accepting new patients | |
| Jefferson Memorial Hospital | Current | Accepting new patients | |
| Jefferson Memorial Hospital | Current | Accepting new patients | |
| City Hospital, Inc. | Current | Accepting new patients | |
| American Anesthesiology of Virginia PC | Current | Accepting new patients | |
| Shenandoah Valley Pathology Laboratories Inc | Current | Accepting new patients | |
| Winchester Medical Center | Current | Accepting new patients | |
| Winchester Anesthesiologists Inc | Current | Accepting new patients | |
| First Colonies Anesthesia Associates, LLC | Nurse Anesthetist, Certified Registered | Current | Accepting new patients |
| Winchester Medical Center | Nurse Anesthetist, Certified Registered | Current | Accepting new patients |
| Winchester Medical Center | Current | Accepting new patients | |
| Jefferson Memorial Hospital | Current | Accepting new patients | |
| City Hospital Inc | Nurse Anesthetist, Certified Registered | Current | Accepting new patients |
| Frederick Health Hospital Inc | Past | Accepting new patients |
Locations
400 W 7th St
Frederick, MD 21701
Phone (240) 566-3300
11116 Medical Campus Rd
Hagerstown, MD 21742
Phone (301) 766-7600
11210 Old Georgetown Rd
Rockville, MD 20852
Phone (301) 881-7770
1500 Forest Glen Rd
Silver Spring, MD 20910
Phone (301) 754-7230
8322 Bellona Ave
Ste 201
Towson, MD 21204
Phone (410) 337-2688
12222 Merit Dr
Ste 600
Dallas, TX 75251
Phone (972) 776-3185
19455 Deerfield Ave
Ste 204
Leesburg, VA 20176
Phone (703) 724-9950
1840 Amherst St
Winchester, VA 22601
Phone (540) 536-8700
1860 Amherst St
Winchester, VA 22601
Phone (540) 536-7870
874 Fox Dr
Winchester, VA 22603
Phone (540) 662-0990
2500 Hospital Dr
Martinsburg, WV 25401
Phone (304) 233-4134
300 S Preston St
Ranson, WV 25438
Phone (304) 728-1600
Organizations & group practices 15
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.
-
dba City Hospital Anesthesia Department
- Anesthesiology Physician
- Martinsburg, WV
- NPI 1942503164
Nurse Anesthetist, Certified Registered
-
- Anesthesiology Physician
- Falls Church, VA
- NPI 1417994872
-
- Anesthesiology Physician
- Winchester, VA
- NPI 1700841137
-
dba Valley Intensivists
- Critical Care Medicine (Internal Medicine) Physician
- Winchester, VA
- NPI 1679711261
-
- Anesthesiology Physician
- Columbia, MD
- NPI 1740218767
DC, Nurse Anesthetist, Certified Registered
-
dba Jefferson Medical Center
- Critical Access Hospital
- Ranson, WV
- NPI 1891722377
-
- Anesthesiology Physician
- Leesburg, VA
- NPI 1053675199
-
- Anatomic Pathology & Clinical Pathology Physician
- Winchester, VA
- NPI 1447363114
-
dba Valley Health Pediatrics Department of Winchester Medical Center
- Pediatrics Physician
- Winchester, VA
- NPI 1013874742
-
- Obstetrics & Gynecology Physician
- Winchester, VA
- NPI 1760433791
Nurse Anesthetist, Certified Registered
-
dba Valley Health Laboratories
- Clinical Medical Laboratory
- Winchester, VA
- NPI 1790024909
-
- Internal Medicine Physician
- Ranson, WV
- NPI 1336657493
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
dba Berkeley Medical Center
- General Acute Care Hospital
- Martinsburg, WV
- NPI 1457389249
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1141084800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1563321600000",
"number": "1659347524",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1840 AMHERST ST",
"city": "WINCHESTER",
"state": "VA",
"postal_code": "226012808",
"telephone_number": "540-536-8000",
"fax_number": "540-536-7681"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1840 AMHERST ST",
"city": "WINCHESTER",
"state": "VA",
"postal_code": "226012808",
"telephone_number": "540-536-8000",
"fax_number": "540-536-7681"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHANHOLTZ",
"first_name": "KELLIE",
"middle_name": "T",
"credential": "CRNA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-02-28",
"last_updated": "2019-07-17",
"status": "A"
},
"taxonomies": [
{
"code": "367500000X",
"taxonomy_group": "",
"desc": "Nurse Anesthetist, Certified Registered",
"state": "MD",
"license": "AC002767",
"primary": true
},
{
"code": "367500000X",
"taxonomy_group": "",
"desc": "Nurse Anesthetist, Certified Registered",
"state": "VA",
"license": "0024134809",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "2604151000",
"state": "WV"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Winchester, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2019; 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.