Individual provider Active NPI

Donald W Shinskie, CRNA

  • Certified Registered Nurse Anesthetist
  • Gulfport, MS
National Provider Identifier
1689700676
Registry record updated Sep 29, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
901620 Issued in MS
Practice address
3017 13TH St
Gulfport, MS 39501-1833
Phone
(228) 831-0050
NPI assigned
Feb 26, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 29, 2020

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

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 170203 NC
Certified Registered Nurse Anesthetist 367500000X 2206 SC
Certified Registered Nurse Anesthetist 367500000X 0001160419 VA
Certified Registered Nurse Anesthetist 367500000X APN0000011680 TN
Certified Registered Nurse Anesthetist 367500000X RN279123L PA
Certified Registered Nurse Anesthetist 367500000X 901620 MS Primary

Addresses

Primary practice location

3017 13TH St
Gulfport, MS 39501-1833

Mailing address

435 Thomas St
Bay St Louis, MS 39520-2019
Phone (910) 389-1260

Other practice location 1

947 Chadwick Shores Dr
Sneads Ferry, NC 28460-9213
Phone (910) 327-0579

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC, TN2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20040720000153 NC Practitioner - Certified Registered Nurse Anesthetist (Crna) 3971582180 Reassigns benefits to 1 organization
I20220707001236 TN Practitioner - Certified Registered Nurse Anesthetist (Crna) 3971582180 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Amsurg Chattanooga Anesthesia LLCGroup PAC ID 8921278821, 9 clinicians

Practice addresses (Care Compare)

1501 Riverside Dr
Suite 117
Chattanooga, TN 37406-4332
Phone (423) 648-0576

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2206SCMDOral and Maxillofacial Surgery (Dentist)
11680TNMDOral & Maxillofacial Surgery (D.M.D.)
901620MSMDPsychiatric/Mental Health Nurse Practitioner
170203NCMDCertified Registered Nurse Anesthetist
RN279123LPAMDCertified Registered Nurse Anesthetist
APN0000011680TNMDCertified Registered Nurse Anesthetist
0001160419VAMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Pender Memorial Hospital, Incorporated CurrentSince Jan 1, 2004 Accepting new patients
Pender Memorial Hospital Incorporated CurrentSince Jan 1, 2004 Accepting new patients
American Anesthesiology of Tennessee, P.C. Nurse Anesthetist, Certified Registered CurrentSince Jun 5, 2022 Accepting new patients
Amsurg Chattanooga Anesthesia LLC CurrentSince Jul 13, 2022 Accepting new patients
Uap Chattanooga Pain, LLC Nurse Anesthetist, Certified Registered CurrentSince May 27, 2023 Accepting new patients
American Anesthesiology of Tennessee, P.C. CurrentSince Jun 5, 2022 Accepting new patients
Onslow Memorial Hospital Inc Past Accepting new patients
Chattanooga Endoscopy ASC LLC PastSince Jul 13, 2022 Accepting new patients

Locations

507 E Fremont St
Burgaw, NC 28425
Phone (910) 259-5451

1305 Walt Whitman Rd
Ste 300
Melville, NY 11747
Phone (516) 370-3796

1501 Riverside Dr
Ste 117
Chattanooga, TN 37406
Phone (423) 648-0576

1016 Executive Dr
Hixson, TN 37343
Phone (423) 414-2770

1016 Executive Dr
Ste 101
Hixson, TN 37343
Phone (423) 648-4525

9300 Park West Blvd
Knoxville, TN 37923
Phone (865) 427-4040

Organizations & group practices 8

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": "1172448000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1601337600000",
    "number": "1689700676",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "435 THOMAS ST",
            "city": "BAY ST LOUIS",
            "state": "MS",
            "postal_code": "395202019",
            "telephone_number": "910-389-1260"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3017 13TH ST",
            "city": "GULFPORT",
            "state": "MS",
            "postal_code": "395011833",
            "telephone_number": "228-831-0050"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "947 Chadwick Shores Dr",
            "address_purpose": "LOCATION",
            "city": "Sneads Ferry",
            "state": "NC",
            "postal_code": "284609213",
            "country_code": "US",
            "telephone_number": "910-327-0579",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHINSKIE",
        "first_name": "DONALD",
        "middle_name": "W",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-26",
        "last_updated": "2020-09-29",
        "certification_date": "2020-09-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "NC",
            "license": "170203",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "SC",
            "license": "2206",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "VA",
            "license": "0001160419",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "TN",
            "license": "APN0000011680",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "PA",
            "license": "RN279123L",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MS",
            "license": "901620",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gulfport, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2020; 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.