Shad Fly

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

AP61299457 Issued in WA

Practice address

800 W 5TH Ave
Spokane, WA 99204-2803

Phone

(509) 458-5800

NPI assigned

Apr 15, 2019

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in WA

Enrollment records 1

Specialty

Certified Registered Nurse Anesthetist (Crna)

Education

Other, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Anesthesia Associates, PSGroup PAC ID 7214823657, 62 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Deaconess Medical Center Hospital, Spokane, WA, CCN 500044
• Multicare Valley Hospital Hospital, Spokane Valley, WA, CCN 500119

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Anesthesia Associates, PS

  • Anesthesiology Physician
  • Spokane, WA
  • NPI 1831143254
  Medicare reassignment Care Compare group NPD

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

• Multicare Health System

  • General Acute Care Hospital
  • Spokane, WA
  • NPI 1356528269
  Care Compare affiliation
• Multicare Health System

  • General Acute Care Hospital
  • Spokane Valley, WA
  • NPI 1538345251
  Care Compare affiliation

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

{
    "created_epoch": "1555286400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655856000000",
    "number": "1861055006",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23225 E MAXWELL AVE",
            "city": "LIBERTY LAKE",
            "state": "WA",
            "postal_code": "990198559",
            "telephone_number": "661-231-5443"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 W 5TH AVE",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992042803",
            "telephone_number": "509-458-5800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FLY",
        "first_name": "SHAD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-04-15",
        "last_updated": "2022-06-22",
        "certification_date": "2022-06-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "WA",
            "license": "AP61299457",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Daniela Tessa Floyd, LMHC
• Jennifer Floyd, LMFT
• John Forrest Floyd, MD
• Steve Floyd
• Joseph Fluckiger, LCSW
• Daniel Alan Flynn III
• FMG East Dalke Avenue Washington LLC
• FMG North Lidgerwood Street Washington LLC
• Zachary Fobar
• Alyssa Belle Fobes

• Certified Registered Nurse Anesthetist in Spokane, WA
• Providers in Spokane, WA by specialty
• Certified Registered Nurse Anesthetist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 2022; 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.