Individual provider Active NPI

Shawn Michael Bumpus

  • Certified Registered Nurse Anesthetist
  • Jasper, IN
National Provider Identifier
1821668435
Registry record updated Jul 31, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
AP61181585 Issued in WA
Practice address
800 W 9TH St
Jasper, IN 47546-2516
Phone
(812) 996-2345
NPI assigned
Jun 26, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 31, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 28274259A IN
Certified Registered Nurse Anesthetist 367500000X AP61181585 WA Primary

Addresses

Primary practice location

800 W 9TH St
Jasper, IN 47546-2516

Mailing address

853 Juniper CT
Jasper, IN 47546-3068

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220810001075 IN Practitioner - Certified Registered Nurse Anesthetist (Crna) 9436552478 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ivory Coast Anesthesia Management LLC 29 clinicians

Practice addresses (Care Compare)

800 W 9TH St
Memorial Hospital and Health Care
Jasper, IN 47546-2514
Phone (812) 996-2345

Hospital & facility affiliations

  • Memorial Hospital and Health Care Center Hospital, Jasper, IN, CCN 150115

Merit-based Incentive Payment System (MIPS)

Final score
89.79 of 100Reported as group
Quality
86.27
Promoting interoperability
100
Improvement activities
40
Cost
79.69

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
28274259AINMDRegistered Nurse
AP61181585WAMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Anesthesiology Group Associates PC Nurse Anesthetist, Certified Registered CurrentSince Aug 3, 2023 Accepting new patients
Ivory Coast Anesthesia Management LLC Nurse Anesthetist, Certified Registered CurrentSince Jan 7, 2024 Accepting new patients

Locations

3700 Washington Ave
Evansville, IN 47714
Phone (812) 232-0021

600 W 13th St
Jasper, IN 47546
Phone (812) 482-7441

800 W 9th St
Jasper, IN 47546
Phone (812) 482-2345

Organizations & group practices 2

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1624665600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690761600000",
    "number": "1821668435",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "853 JUNIPER CT",
            "city": "JASPER",
            "state": "IN",
            "postal_code": "475463068"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 W 9TH ST",
            "city": "JASPER",
            "state": "IN",
            "postal_code": "475462516",
            "telephone_number": "812-996-2345"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUMPUS",
        "first_name": "SHAWN",
        "middle_name": "MICHAEL",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-06-26",
        "last_updated": "2023-07-31",
        "certification_date": "2023-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "IN",
            "license": "28274259A",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "WA",
            "license": "AP61181585",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jasper, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2023; 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.

Verify at the official NPI Registry.