Active NPI
Shanericka Reshonet Jones, CRNA
- Certified Registered Nurse Anesthetist
- Fairfax, VA
National Provider Identifier
1730325762
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Certified Registered Nurse Anesthetist
- License
- 0024171084
- Practice address
- 3998 Fair Ridge Drive
Suite 320
Fairfax, VA 22033-2921 - Phone
- (703) 295-9360
- Fax
- (703) 295-9369
- NPI assigned
- Dec 22, 2008
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 157231 | TN | |
| Certified Registered Nurse Anesthetist | 367500000X | 13884 | TN | |
| Certified Registered Nurse Anesthetist | 367500000X | 0024171084 | VA | Primary |
Addresses
Primary practice location
3998 Fair Ridge Drive
Suite 320
Fairfax, VA 22033-2921
Mailing address
PO Box 37090
Baltimore, MD 21297-3090
Phone (703) 295-9360
Other identifiers 6
| Identifier | Type | State | Issuer |
|---|---|---|---|
| P00711618 | Other | TN | RAILROAD MEDICARE |
| 04870087 | Medicaid | MS | |
| 1511595 | Medicaid | TN | |
| 1730325762 | Other | CHAMPUS/HUMANA TRICARE | |
| 186289001 | Medicaid | AR | |
| 4205212 | Other | TN | BLUE CROSS |
Other names 1
- Miss Cissy Reshonet Jones
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in DC, VA, MS
Enrollment records 3
Care Compare profile
Medicare Care Compare- Specialty
- Certified Registered Nurse Anesthetist (Crna)
- Education
- Other, 2008
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
4500 13TH St
Gulfport, MS 39501-2515
Phone (228) 867-4000
Hospital & facility affiliations
- Memorial Hospital at Gulfport
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Certified Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 157231 | TN | MD | Registered Nurse |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| American Anesthesiology of Virginia, PC | Current | Accepting new patients | |
| American Anesthesiology of Virginia PC | Current | Accepting new patients | |
| Etas, PLLC | Current | Accepting new patients |
Locations
7956 Vaughn Rd
Ste 165
Montgomery, AL 36116
4500 13th St
Fl 2
Gulfport, MS 39501
Phone (228) 865-3281
4500 13th St
Gulfport, MS 39501
Phone (228) 236-3872
3600 Joseph Siewick Dr
Fairfax, VA 22033
Phone (703) 391-3037
3300 Gallows Rd
Falls Church, VA 22042
Phone (703) 352-9395
19455 Deerfield Ave
Ste 204
Leesburg, VA 20176
Phone (703) 724-9950
Organizations & group practices 3
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
- Gulfport, MS
- NPI 1679259360
-
- Anesthesiology Physician
- Leesburg, VA
- NPI 1053675199
Hospital & facility affiliations 60
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Gulfport, MS
- NPI 1073606901
-
- Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
- Gulfport, MS
- NPI 1184956815
Hospital
-
- General Acute Care Hospital
- Biloxi, MS
- NPI 1215546635
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1229904000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1377648000000",
"number": "1730325762",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 37090",
"city": "BALTIMORE",
"state": "MD",
"postal_code": "212973090",
"telephone_number": "703-295-9360",
"fax_number": "703-295-9369"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3998 FAIR RIDGE DRIVE",
"address_2": "SUITE 320",
"city": "FAIRFAX",
"state": "VA",
"postal_code": "220332921",
"telephone_number": "703-295-9360",
"fax_number": "703-295-9369"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JONES",
"first_name": "SHANERICKA",
"middle_name": "RESHONET",
"name_prefix": "Miss",
"credential": "CRNA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2008-12-22",
"last_updated": "2013-08-28",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "TN",
"license": "157231",
"primary": false
},
{
"code": "367500000X",
"taxonomy_group": "",
"desc": "Nurse Anesthetist, Certified Registered",
"state": "TN",
"license": "13884",
"primary": false
},
{
"code": "367500000X",
"taxonomy_group": "",
"desc": "Nurse Anesthetist, Certified Registered",
"state": "VA",
"license": "0024171084",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "P00711618",
"state": "TN"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "04870087",
"state": "MS"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1511595",
"state": "TN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CHAMPUS/HUMANA TRICARE",
"identifier": "1730325762",
"state": null
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "186289001",
"state": "AR"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS",
"identifier": "4205212",
"state": "TN"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "CISSY",
"last_name": "JONES",
"middle_name": "RESHONET",
"prefix": "MISS",
"credential": "CRNA",
"code": "5",
"type": "Other Name"
}
]
}Other providers in Fairfax, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2013; 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.