Individual provider Active NPI

Shellye D Stevenson, CRNA

  • Certified Registered Nurse Anesthetist
  • Hot Springs, AR
National Provider Identifier
1669482238
Registry record updated Jan 25, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
C003027 Issued in AR
Practice address
1910 Malvern Ave
Hot Springs, AR 71901-7752
Phone
(501) 321-1000
NPI assigned
Aug 8, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 25, 2017

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 148160 MO
Certified Registered Nurse Anesthetist 367500000X C003027 AR Primary

Addresses

Primary practice location

1910 Malvern Ave
Hot Springs, AR 71901-7752

Mailing address

PO Box 22390
Hot Springs, AR 71903-2390
Phone (877) 649-7812

Other names 1

  • Shelly D Stevenson Other name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150107000558 AR Practitioner - Certified Registered Nurse Anesthetist (Crna) 4486829041 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ouachita Regional Anesthesia PLLCGroup PAC ID 4183619216, 18 clinicians

Practice addresses (Care Compare)

8820 Knoedl CT
Little Rock, AR 72205-4600
Phone (501) 224-6767

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
148160MOMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Ouachita Regional Anesthesia PLLC CurrentSince Dec 1, 2016 Accepting new patients

Locations

1910 Malvern Ave
Hot Springs National Park, AR 71901
Phone (501) 321-1000

8820 Knoedl Ct
Little Rock, AR 72205
Phone (501) 224-6767

Organizations & group practices 1

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": "1154995200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1485302400000",
    "number": "1669482238",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 22390",
            "city": "HOT SPRINGS",
            "state": "AR",
            "postal_code": "719032390",
            "telephone_number": "877-649-7812",
            "fax_number": "918-392-2941"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1910 MALVERN AVE",
            "city": "HOT SPRINGS",
            "state": "AR",
            "postal_code": "719017752",
            "telephone_number": "501-321-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STEVENSON",
        "first_name": "SHELLYE",
        "middle_name": "D",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-08",
        "last_updated": "2017-01-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MO",
            "license": "148160",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "AR",
            "license": "C003027",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SHELLY",
            "last_name": "STEVENSON",
            "middle_name": "D",
            "credential": "CRNA",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Hot Springs, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 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.