Active NPI
Lawrence M. Shovelton, CRNA
- Certified Registered Nurse Anesthetist
- Salida, CO
National Provider Identifier
1710967864
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Certified Registered Nurse Anesthetist
- License
- 172781
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 30437873 | Medicaid | CO | |
| 4702 | Other | CO | CRNA |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 172781 | CO | MD | Certified Registered Nurse Anesthetist |
Practice roles
| Organization | Specialty | Status | New 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.
-
- Anesthesiology Physician
- Aurora, CO
- NPI 1972555928
-
- Anesthesiology Physician
- Carlsbad, NM
- NPI 1518904168
-
- Health Service Clinic/Center
- Brewer, ME
- NPI 1780821140
-
- Critical Access Hospital
- Blue Hill, ME
- NPI 1023057809
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.