NPIMap

Individual provider Active NPI

Shana Fearnley, PA-C

  • Surgical Physician Assistant
  • Reno, NV
National Provider Identifier
1861480642
Registry record updated Aug 25, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
PA730 Issued in NV
Practice address
9990 Double R Blvd Ste 200
Reno, NV 89521-4833
Phone
(775) 348-8800
Fax
(775) 348-8818
NPI assigned
Oct 6, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 25, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X PA730 NV Primary

Addresses

Primary practice location

9990 Double R Blvd Ste 200
Reno, NV 89521-4833

Mailing address

5310 Kietzke LN Ste 104
Reno, NV 89511-2043
Phone (775) 348-8800

Other identifiers 2

IdentifierTypeStateIssuer
11426227OtherCAQH
1861480642MedicaidNV

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address sfearnley2248@Direct.renown.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NV
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100122000787 NV Practitioner - Physician Assistant 8820130222 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
James J Lynch M D LTDGroup PAC ID 9133188626, 81 clinicians
Custom Physical Therapy Limited PartnershipGroup PAC ID 1355252842, shared by 2 NPIs, 76 clinicians

Practice addresses (Care Compare)

10539 Professional Cir
Suite 201
Reno, NV 89521-3858
Phone (775) 793-6190

1470 Medical Pkwy
Suite 220
Carson City, NV 89703-4647
Phone (775) 348-8800

440 E Golden Valley Rd
Suite Aandb
Reno, NV 89506-5722
Phone (775) 360-3000

780 Vista Blvd
Suite 100
Sparks, NV 89434-6677
Phone (775) 348-8800

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
90.71 of 100Reported as apm
Quality
81.42
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA730NVMDSurgical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
James J Lynch MD LTD CurrentSince Sep 1, 2022 Accepting new patients
James J Lynch M D LTD CurrentSince Sep 1, 2022 Accepting new patients
Orthopedic Associates of Peoria, S.C. Past Accepting new patients

Locations

1470 Medical Pkwy
Ste 220
Carson City, NV 89703

10539 Professional Cir
Ste 201
Reno, NV 89521
Phone (775) 674-5632

5310 Kietzke Ln
Ste 104
Reno, NV 89511

9990 Double R Blvd
Ste 200
Reno, NV 89521
Phone (753) 488-8008

780 Vista Blvd
Ste 100
Sparks, NV 89434
Phone (753) 348-8800

780 Vista Blvd
Ste 101
Sparks, NV 89434

Interoperability endpoints

  • Direct secure messaging: shana.fearnley.1@22724.direct.athenahealth.com
  • Direct secure messaging: sfearnley2248@direct.renown.org

Organizations & group practices 4

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 10

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": "1128556800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661385600000",
    "number": "1861480642",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5310 KIETZKE LN STE 104",
            "city": "RENO",
            "state": "NV",
            "postal_code": "895112043",
            "telephone_number": "775-348-8800",
            "fax_number": "775-786-1887"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9990 DOUBLE R BLVD STE 200",
            "city": "RENO",
            "state": "NV",
            "postal_code": "895214833",
            "telephone_number": "775-348-8800",
            "fax_number": "775-348-8818"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FEARNLEY",
        "first_name": "SHANA",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-10-06",
        "last_updated": "2022-08-25",
        "certification_date": "2022-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "NV",
            "license": "PA730",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH",
            "identifier": "11426227",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1861480642",
            "state": "NV"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "sfearnley2248@Direct.renown.org",
            "affiliation": "N",
            "address_1": "555 N Arlington Ave",
            "city": "Reno",
            "state": "NV",
            "country_code": "US",
            "postal_code": "895034723",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Reno, NV

Sources for this page

Verify at the official NPI Registry.