Connie Michelle Shively, CRNA

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

60181 Issued in LA

Practice address

1118 S Farmerville St
Ruston, LA 71270-5914

Phone

(318) 723-2770

Fax

(318) 232-1092

NPI assigned

Feb 27, 2007

Last updated

Aug 14, 2007By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in LA

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Registered Nurse, Master of Science - Nursing

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir-myrecord.cerner.com/r4/21ed112e-ec5e-43b1-8ddc-cd3753841e6e/

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.

• Arena Anesthesia LLC

  • Anesthesiology Physician
  • Ruston, LA
  • NPI 1023244779

  Nurse Anesthetist, Certified Registered

  Medicare reassignment NPD
• Bayou Anesthesia Group LLC

  • Certified Registered Nurse Anesthetist
  • Farmerville, LA
  • NPI 1528365947

  Nurse Anesthetist, Certified Registered

  Medicare reassignment NPD
• Christus Health Northern Louisiana

  dba Christus Shreveport-Bossier Health System

  • Certified Registered Nurse Anesthetist
  • Shreveport, LA
  • NPI 1801822762

  Nurse Anesthetist, Certified Registered

  Medicare reassignment NPD
• Jackson Parish Hospital

  • Critical Access Hospital
  • Jonesboro, LA
  • NPI 1093793408
  Medicare reassignment NPD
• Medical Center Anesthesiologists

  • Anesthesiology Physician
  • Shreveport, LA
  • NPI 1669469748
  Medicare reassignment NPD
• Sayer & Soileau Anesthesia, LLC

  • Certified Registered Nurse Anesthetist
  • Marksville, LA
  • NPI 1629521604

  Nurse Anesthetist, Certified Registered

  Medicare reassignment NPD
• Shreveport Sedation Associates LLC

  • Certified Registered Nurse Anesthetist
  • Shreveport, LA
  • NPI 1770083164

  Nurse Anesthetist, Certified Registered

  Medicare reassignment NPD
• Anesthesia Dynamics LLC

  • Anesthesiology Physician
  • Bradenton, FL
  • NPI 1073001012

  LA, Nurse Anesthetist, Certified Registered

  Medicare reassignment NPD
• Orthomed Staffing LLC

  • Anesthesiology Physician
  • Addison, TX
  • NPI 1225514276

  LA

  Medicare reassignment NPD
• Harold J Bayonne Jr MD Apmc

  • Anesthesiology Physician
  • Monroe, LA
  • NPI 1356886774
  Medicare reassignment
• Christus Health Northern Louisiana

  dba Christus Shreveport-Bossier Health System

  • General Acute Care Hospital
  • Shreveport, LA
  • NPI 1417950106
  NPD
• LGH Oncology Clinic

  • Hematology & Oncology Physician
  • Ruston, LA
  • NPI 1225133622
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1172534400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1187049600000",
    "number": "1689701872",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "420 RISER RD",
            "city": "RUSTON",
            "state": "LA",
            "postal_code": "712709131",
            "telephone_number": "318-232-7700",
            "fax_number": "318-232-1092"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1118 S FARMERVILLE ST",
            "city": "RUSTON",
            "state": "LA",
            "postal_code": "712705914",
            "telephone_number": "318-723-2770",
            "fax_number": "318-232-1092"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHIVELY",
        "first_name": "CONNIE",
        "middle_name": "MICHELLE",
        "name_prefix": "Mrs.",
        "credential": "CRNA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-02-27",
        "last_updated": "2007-08-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "LA",
            "license": "60181",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jodi Serpas, DPT
• Shanti Health Services LLC
• Navneet Sharma, M.D.
• Bonnie Jennifer Sherrard, FNP-C
• Matthew Shirley, PT
• Sheryl Stokes Shoemaker, AU.D.
• Shreveport Mental Health Center
• Keshia Simmons
• Tamara Simpson Davis, M.ED., LPC, NCC
• Shelby Nicole Simpson

• Certified Registered Nurse Anesthetist in Ruston, LA
• Providers in Ruston, LA by specialty
• Certified Registered Nurse Anesthetist in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.