Individual provider Active NPI

Kyle Andrew Shnowski, CRNA

  • Certified Registered Nurse Anesthetist
  • Victoria, TX
National Provider Identifier
1851809982
Registry record updated Aug 28, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
AP136211 Issued in TX
Practice address
2701 Hospital Dr
Victoria, TX 77901
Phone
(361) 573-6291
Fax
(361) 576-2434
NPI assigned
Jan 10, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 28, 2018

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 840899 TX
Certified Registered Nurse Anesthetist 367500000X AP136211 TX Primary

Addresses

Primary practice location

2701 Hospital Dr
Victoria, TX 77901

Mailing address

1501 E Mockingbird LN Ste 101
Victoria, TX 77904-2178
Phone (361) 573-6291

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180130001310 TX Practitioner - Certified Registered Nurse Anesthetist (Crna) 8325308927 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
840899TXMDRegistered Nurse
AP136211TXMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Northstar Anesthesia, PA Nurse Anesthetist, Certified Registered CurrentSince Apr 1, 2022 Accepting new patients

Locations

909 9th Ave
Ft Worth, TX 76104
Phone (817) 336-6060

6200 W Parker Rd
Plano, TX 75093
Phone (972) 608-8000

506 E San Antonio St
Victoria, TX 77901
Phone (361) 575-1445

101 Medical Dr
Victoria, TX 77904
Phone (361) 573-6100

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.

NPI Registry JSON

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

{
    "created_epoch": "1515542400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1535414400000",
    "number": "1851809982",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1501 E MOCKINGBIRD LN STE 101",
            "city": "VICTORIA",
            "state": "TX",
            "postal_code": "779042178",
            "telephone_number": "361-573-6291",
            "fax_number": "361-576-2434"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2701 HOSPITAL DR",
            "city": "VICTORIA",
            "state": "TX",
            "postal_code": "77901",
            "telephone_number": "361-573-6291",
            "fax_number": "361-576-2434"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHNOWSKI",
        "first_name": "KYLE",
        "middle_name": "ANDREW",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-01-10",
        "last_updated": "2018-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "TX",
            "license": "840899",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "TX",
            "license": "AP136211",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Victoria, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2018; 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.