Individual provider Active NPI

Adam Patrick Shindle

  • Certified Registered Nurse Anesthetist
  • Simpsonville, SC
National Provider Identifier
1902381486
Registry record updated Jan 21, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
APRN11000969 Issued in FL
Practice address
109 Joseph Fletcher Way
Simpsonville, SC 29681-5467
Phone
(864) 979-6079
NPI assigned
Oct 1, 2018
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 21, 2019

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 APRN11000969 FL Primary
Critical Care Medicine Registered Nurse 163WC0200X RN9366583 FL

Addresses

Primary practice location

109 Joseph Fletcher Way
Simpsonville, SC 29681-5467

Mailing address

109 Joseph Fletcher Way
Simpsonville, SC 29681-5467
Phone (864) 979-6079

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190222000661 FL Practitioner - Certified Registered Nurse Anesthetist (Crna) 5991044737 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sunshine State Anesthesia Partners LLCGroup PAC ID 8123434792, 429 clinicians

Practice addresses (Care Compare)

2901 B Swann Ave
Tampa, FL 33609-4056
Phone (813) 873-6400

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RN9366583FLMDCritical Care Medicine Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Gulf-to-Bay Anesthesiology Associates LLC CurrentSince Feb 1, 2019 Accepting new patients
Gulf-to-Bay Anesthesiology Associates LLC CurrentSince Feb 1, 2019 Accepting new patients
Sunshine State Anesthesia Partners LLC CurrentSince Nov 10, 2021 Accepting new patients

Locations

24040 Tamiami Trl
Bonita Springs, FL 34134
Phone (239) 624-7153

14000 Fivay Rd
Hudson, FL 34667
Phone (727) 819-2929

15238 Virginia Sta
Odessa, FL 33556
Phone (813) 596-5200

11375 Cortez Blvd
#50
Spring Hill, FL 34613
Phone (352) 592-2753

4016 Sun City Center Blvd
Sun City Ctr, FL 33573
Phone (813) 634-0145

2901 W Swann Ave
Tampa, FL 33609
Phone (813) 783-6400

1 Tampa General Cir
University of Tampa, FL 33606
Phone (813) 251-5822

Organizations & group practices 3

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": "1538352000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1548028800000",
    "number": "1902381486",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "109 JOSEPH FLETCHER WAY",
            "city": "SIMPSONVILLE",
            "state": "SC",
            "postal_code": "296815467",
            "telephone_number": "864-979-6079"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "109 JOSEPH FLETCHER WAY",
            "city": "SIMPSONVILLE",
            "state": "SC",
            "postal_code": "296815467",
            "telephone_number": "864-979-6079"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHINDLE",
        "first_name": "ADAM",
        "middle_name": "PATRICK",
        "name_prefix": "Mr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-10-01",
        "last_updated": "2019-01-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "FL",
            "license": "APRN11000969",
            "primary": true
        },
        {
            "code": "163WC0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Critical Care Medicine",
            "state": "FL",
            "license": "RN9366583",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Simpsonville, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 2019; 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.