Individual provider Active NPI

Lawrence M. Shovelton, CRNA

  • Certified Registered Nurse Anesthetist
  • Salida, CO
National Provider Identifier
1710967864
Registry record updated Apr 4, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
172781 Issued in CO
Practice address
29 Silver Spruce Dr
Salida, CO 81201-9483
Phone
(719) 325-6871
NPI assigned
Jan 17, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 4, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 172781 CO Primary

Addresses

Primary practice location

29 Silver Spruce Dr
Salida, CO 81201-9483

Mailing address

310 County Road 14
Del Norte, CO 81132-8719
Phone (719) 657-4102

Other identifiers 2

IdentifierTypeStateIssuer
30437873MedicaidCO
4702OtherCOCRNA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
172781COMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Carlsbad Medical Center LLC Anesthesiology Past Accepting new patients
Norumbega Medical Specialists, LTD Past Accepting new patients
Colorado Personnel Resources Inc Anesthesiology Past Accepting new patients
The Blue Hill Memorial Hospital Past Accepting new patients

Organizations & group practices 4

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": "1137456000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1491264000000",
    "number": "1710967864",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "310 COUNTY ROAD 14",
            "city": "DEL NORTE",
            "state": "CO",
            "postal_code": "811328719",
            "telephone_number": "719-657-4102",
            "fax_number": "719-657-4106"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "29 SILVER SPRUCE DR",
            "city": "SALIDA",
            "state": "CO",
            "postal_code": "812019483",
            "telephone_number": "719-325-6871"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHOVELTON",
        "first_name": "LAWRENCE",
        "middle_name": "M.",
        "name_prefix": "Mr.",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-17",
        "last_updated": "2017-04-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "CO",
            "license": "172781",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30437873",
            "state": "CO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CRNA",
            "identifier": "4702",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Salida, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 4, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.