Individual provider Active NPI

Ryan Michael Shedd, CRNA

  • Certified Registered Nurse Anesthetist
  • Powell, WY
National Provider Identifier
1841259355
Registry record updated Jan 7, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
ARNP9172706 Issued in FL
Practice address
777 Avenue H
Powell, WY 82435
Phone
(307) 754-7257
Fax
(307) 754-7751
NPI assigned
Mar 22, 2006
Last updated
Jan 7, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 7, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 43-557662 KS
Certified Registered Nurse Anesthetist 367500000X ARNP9172706 FL Primary

Addresses

Primary practice location

777 Avenue H
Powell, WY 82435

Mailing address

777 Avenue H
Powell, WY 82435
Phone (307) 754-7257

Other identifiers 1

IdentifierTypeStateIssuer
306250300MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WY, CO2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20140224000562 WY Practitioner - Certified Registered Nurse Anesthetist (Crna) 5991784589 Reassigns benefits to 4 organizations
I20171023000792 CO Practitioner - Certified Registered Nurse Anesthetist (Crna) 5991784589 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1284WYMDProfessional Counselor
43-557662KSMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Jax Anesthesia Providers Current Accepting new patients
Anesthesia Associates of Clay County Past Accepting new patients
Hodgeman County Health Center Past Accepting new patients

Locations

4800 Belfort Rd
Jacksonville, FL 32256
Phone (904) 307-2084

4800 Belfort Rd
Fl 3
Jacksonville, FL 32256
Phone (904) 265-6478

Interoperability endpoints

  • Direct secure messaging: rshedd@hscmh.cernerdirect.com

Organizations & group practices 8

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.

NPI Registry JSON

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

{
    "created_epoch": "1142985600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1578355200000",
    "number": "1841259355",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "777 AVENUE H",
            "city": "POWELL",
            "state": "WY",
            "postal_code": "82435",
            "telephone_number": "307-754-7257",
            "fax_number": "307-754-7751"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "777 AVENUE H",
            "city": "POWELL",
            "state": "WY",
            "postal_code": "82435",
            "telephone_number": "307-754-7257",
            "fax_number": "307-754-7751"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHEDD",
        "first_name": "RYAN",
        "middle_name": "MICHAEL",
        "name_prefix": "Mr.",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-22",
        "last_updated": "2020-01-07",
        "certification_date": "2020-01-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "KS",
            "license": "43-557662",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "FL",
            "license": "ARNP9172706",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "306250300",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Powell, WY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.