Active NPI
Jason P. Shaffer, CRNA
- Certified Registered Nurse Anesthetist
- Saint Louis, MO
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Certified Registered Nurse Anesthetist
- License
- 2010001182
- Practice address
- 6420 Clayton Rd
Saint Louis, MO 63117-1811 - Phone
- (314) 768-8442
- Fax
- (314) 768-8918
- NPI assigned
- Jan 18, 2010
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Certified Registered Nurse Anesthetist | 367500000X | 2010001182 | MO | Primary |
Addresses
Primary practice location
6420 Clayton Rd
Saint Louis, MO 63117-1811
Mailing address
6420 Clayton Rd
Saint Louis, MO 63117-1811
Phone (314) 768-8442
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MO
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Certified Registered Nurse Anesthetist (Crna)
- Education
- Southern Illinois University School of Medicine, 2010
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1400 US Hwy 61
Festus, MO 63028-4100
Phone (636) 933-1000
Hospital & facility affiliations
- Mercy Hospital Jefferson
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Certified Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2010001182 | MO | MD | Certified Registered Nurse Anesthetist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Acuity Anesthesiology LLC | Current | Accepting new patients |
Locations
865406 Reliable Pkwy
Chicago, IL 60686
1400 US Highway 61
Crystal Cty, MO 63028
Phone (636) 933-1111
Organizations & group practices 1
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.
-
- Anesthesiology Physician
- Festus, MO
- NPI 1134353030
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Festus, MO
- NPI 1508859661
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1263772800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1263772800000",
"number": "1912238809",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6420 CLAYTON RD",
"city": "SAINT LOUIS",
"state": "MO",
"postal_code": "631171811",
"telephone_number": "314-768-8442",
"fax_number": "314-768-8918"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6420 CLAYTON RD",
"city": "SAINT LOUIS",
"state": "MO",
"postal_code": "631171811",
"telephone_number": "314-768-8442",
"fax_number": "314-768-8918"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHAFFER",
"first_name": "JASON",
"middle_name": "P.",
"credential": "CRNA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2010-01-18",
"last_updated": "2010-01-18",
"status": "A"
},
"taxonomies": [
{
"code": "367500000X",
"taxonomy_group": "",
"desc": "Nurse Anesthetist, Certified Registered",
"state": "MO",
"license": "2010001182",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Saint Louis, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 2010; 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.