Active NPI
Glenn Daniel Shupe, CRNA
- Certified Registered Nurse Anesthetist
- Phoenix, AZ
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Certified Registered Nurse Anesthetist
- License
- RN130186
- Practice address
- 5777 E Mayo Blvd
Phoenix, AZ 85054-4502 - Phone
- (480) 301-8000
- NPI assigned
- Dec 6, 2005
- 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 | RN130186 | AZ | Primary |
Addresses
Primary practice location
5777 E Mayo Blvd
Phoenix, AZ 85054-4502
Mailing address
5777 E Mayo Blvd
Phoenix, AZ 85054-4502
Phone (480) 301-8000
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 893158 | Medicaid | AZ | |
| 86080015085259A968 | Other | AZ | TRIWEST |
| 86080015085260A111 | Other | AZ | TRIWEST |
| P00169405 | Other | AZ | RAILROAD MEDICARE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in AZ
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Certified Registered Nurse Anesthetist (Crna)
- Education
- Other, 2004
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
3929 E Bell Rd
Phoenix, AZ 85032-2112
Phone (623) 923-5000
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Certified Registered Nurse
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Ascend Anesthesia LLC | Nurse Anesthetist, Certified Registered | Current | Accepting new patients |
| Summit Anesthesia Services PLLC | Nurse Anesthetist, Certified Registered | Current | Accepting new patients |
| Anesthesia Partners & Management LLC | Nurse Anesthetist, Certified Registered | Current | Accepting new patients |
| Novaspine Pain Institute, PLC | Current | Accepting new patients | |
| Novaspine Pain Institute, PLC | Current | Accepting new patients | |
| Integrated Anesthesia Consultants PLC | Current | Accepting new patients | |
| Pinnacle Global Health LLC | Past | Accepting new patients |
Locations
900 N San Francisco St
Flagstaff, AZ 86001
Phone (928) 779-7000
1020 N San Francisco St
Ste 100
Flagstaff, AZ 86001
Phone (928) 774-2300
2450 E Guadalupe Rd
Ste 101
Gilbert, AZ 85234
Phone (480) 398-8456
3615 S Rome St
Gilbert, AZ 85297
Phone (480) 245-4425
3420 S Mercy Rd
Ste 200
Gilbert, AZ 85297
Phone (480) 909-3787
18555 N 79th Ave
Bldg C
Glendale, AZ 85308
Phone (623) 776-2500
103 Medicine Way Rd
Peridot, AZ 85542
Phone (928) 475-1200
1902 W Union Hills Dr
Unit 41340
Phoenix, AZ 85080
4600 E Washington St
Ste 300
Phoenix, AZ 85034
Phone (602) 638-1872
3900 E Camelback Rd
Ste 190
Phoenix, AZ 85018
Phone (888) 724-6236
1902 W Union Hills Dr
Unit 41550
Phoenix, AZ 85080
3929 E Bell Rd
Phoenix, AZ 85032
Phone (602) 923-5000
7301 N 16th St
Ste 102
Phoenix, AZ 85020
Phone (602) 772-8600
3110 Clearwater Dr
Prescott, AZ 86305
Phone (623) 241-6185
5430 Distinction Way
Prescott, AZ 86301
Phone (928) 445-1919
8952 E Desert Cove Ave
Ste 113
Scottsdale, AZ 85260
Phone (480) 314-7772
10494 W Thunderbird Blvd
Ste 102
Sun City, AZ 85351
Phone (623) 975-8311
13203 N 103rd Ave
Ste H5
Sun City, AZ 85351
Phone 62377747474789
10503 W Thunderbird Blvd
Ste 317
Sun City, AZ 85351
Phone (623) 546-1400
14300 W Granite Valley Dr
Ste A1
Sun City West, AZ 85375
Phone (602) 546-4934
1704 W Anklam Rd
Ste 108
Tucson, AZ 85745
Phone (623) 241-6185
Organizations & group practices 7
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.
-
- Certified Registered Nurse Anesthetist
- Phoenix, AZ
- NPI 1821589144
Nurse Anesthetist, Certified Registered
-
- Certified Registered Nurse Anesthetist
- Mesa, AZ
- NPI 1407642945
Nurse Anesthetist, Certified Registered
-
- Anesthesiology Physician
- Gilbert, AZ
- NPI 1144645656
-
- Pain Medicine Physician
- Sun City West, AZ
- NPI 1154745263
-
dba Arizona Anesthesia Solutions
- Certified Registered Nurse Anesthetist
- Brighton, MI
- NPI 1336530997
AZ, Nurse Anesthetist, Certified Registered
-
- Pain Medicine Physician
- Sun City West, AZ
- NPI 1265233019
-
- Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
- Phoenix, AZ
- NPI 1114832417
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1133827200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1526342400000",
"number": "1821072455",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5777 E MAYO BLVD",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "850544502",
"telephone_number": "480-301-8000"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5777 E MAYO BLVD",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "850544502",
"telephone_number": "480-301-8000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHUPE",
"first_name": "GLENN",
"middle_name": "DANIEL",
"credential": "CRNA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-12-06",
"last_updated": "2018-05-15",
"status": "A"
},
"taxonomies": [
{
"code": "367500000X",
"taxonomy_group": "",
"desc": "Nurse Anesthetist, Certified Registered",
"state": "AZ",
"license": "RN130186",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "893158",
"state": "AZ"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TRIWEST",
"identifier": "86080015085259A968",
"state": "AZ"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TRIWEST",
"identifier": "86080015085260A111",
"state": "AZ"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "P00169405",
"state": "AZ"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Phoenix, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 2018; 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.