Individual provider Active NPI

Shannon C Bormann, CRNA

  • Certified Registered Nurse Anesthetist
  • Indianapolis, IN
National Provider Identifier
1912427188
Registry record updated May 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
28199577A Issued in IN
Practice address
705 Riley Hospital Dr
Indianapolis, IN 46202-5109
Phone
(317) 944-4044
NPI assigned
Jun 20, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 16, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 28199577A IN
Certified Registered Nurse Anesthetist 367500000X 28199577A IN Primary

Addresses

Primary practice location

705 Riley Hospital Dr
Indianapolis, IN 46202-5109

Mailing address

250 N Shadeland Ave
Indianapolis, IN 46219-4959

Other practice location 1

2600 Greenbush St
Lafayette, IN 47904-2477
Phone (765) 448-8000

Other practice location 2

1111 Ronald Reagan Pkwy
Avon, IN 46123-7085
Phone (317) 577-4200

Other practice location 3

1701 N Senate Blvd
Indianapolis, IN 46202-1239
Phone (888) 484-3258

Other identifiers 2

IdentifierTypeStateIssuer
000001135802OtherINANTHEM PROVIDER NUMBER
300009668MedicaidIN

Electronic endpoints 3

TypeEndpointUseAffiliation
Direct Messaging Address sbormann@direct.iuhealth.org
Direct Messaging Address sbormann@direct.iuhealth.org Direct
Direct Messaging Address sbormann@direct.iuhealth.org Direct

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20171218002676 IN Practitioner - Certified Registered Nurse Anesthetist (Crna) 4082972138 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Iu Health Medical Group LLCGroup PAC ID 9638617913, 4,382 clinicians
Aas Indiana LLCGroup PAC ID 4688045115, 43 clinicians

Practice addresses (Care Compare)

1701 N Senate Blvd
Indianapolis, IN 46202-1239
Phone (888) 484-3258

4105 Dicke Rd
Fort Wayne, IN 46804-6135
Phone (260) 268-1000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
28199577AINMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Arnett Clinic, LLC Pediatrics CurrentSince Jan 1, 2018 Accepting new patients
Arnett Clinic, LLC Current Accepting new patients
Arnett Clinic, LLC CurrentSince Jan 1, 2018 Accepting new patients
Aas Indiana LLC Nurse Anesthetist, Certified Registered CurrentSince Nov 1, 2023 Accepting new patients
Iu Health Medical Group, LLC Nurse Anesthetist, Certified Registered CurrentSince Jul 1, 2025 Accepting new patients
Indiana University Health Care Associates, Inc CurrentSince Jan 1, 2025 Accepting new patients
University Medical Diagnostic Associates, Inc. Past Accepting new patients

Locations

5208 Reliable Pkwy
Chicago, IL 60686

8016 Reliable Pkwy
Chicago, IL 60686

1111 Ronald Reagan Pkwy
Avon, IN 46123
Phone (317) 217-3000

10300 N Illinois St
Ste 1300
Carmel, IN 46290
Phone (317) 688-3690

4105 Dicke Rd
Fort Wayne, IN 46804
Phone (260) 268-1000

1701 N Senate Blvd
Bldg C6
Indianapolis, IN 46202
Phone (913) 962-2000

250 N Shadeland Ave
Indianapolis, IN 46219
Phone (317) 948-9174

550 University Blvd
#4100
Indianapolis, IN 46202
Phone (317) 274-3106

705 Riley Hospital Dr
Indianapolis, IN 46202
Phone (317) 274-4779

1701 Senate Blvd
Indianapolis, IN 46202
Phone (317) 612-2754

2600 Greenbush St
Lafayette, IN 47904

2401 W University Ave
Muncie, IN 47303
Phone (765) 747-3111

Interoperability endpoints

  • Direct secure messaging: sbormann@direct.iuhealth.org

Organizations & group practices 7

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 2

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": "1497916800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747353600000",
    "number": "1912427188",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "250 N SHADELAND AVE",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462194959"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "705 RILEY HOSPITAL DR",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462025109",
            "telephone_number": "317-944-4044"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2600 Greenbush St",
            "address_purpose": "LOCATION",
            "city": "Lafayette",
            "state": "IN",
            "postal_code": "479042477",
            "country_code": "US",
            "telephone_number": "765-448-8000",
            "fax_number": "765-838-5150",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1111 Ronald Reagan Pkwy",
            "address_purpose": "LOCATION",
            "city": "Avon",
            "state": "IN",
            "postal_code": "461237085",
            "country_code": "US",
            "telephone_number": "317-577-4200",
            "fax_number": "317-577-4200",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1701 N Senate Blvd",
            "address_purpose": "LOCATION",
            "city": "Indianapolis",
            "state": "IN",
            "postal_code": "462021239",
            "country_code": "US",
            "telephone_number": "888-484-3258",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BORMANN",
        "first_name": "SHANNON",
        "middle_name": "C",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-06-20",
        "last_updated": "2025-05-16",
        "certification_date": "2025-05-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "IN",
            "license": "28199577A",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "IN",
            "license": "28199577A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM PROVIDER NUMBER",
            "identifier": "000001135802",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "300009668",
            "state": "IN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "sbormann@direct.iuhealth.org",
            "affiliation": "N",
            "address_1": "2600 Greenbush St",
            "city": "Lafayette",
            "state": "IN",
            "country_code": "US",
            "postal_code": "479042477",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "sbormann@direct.iuhealth.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1111 Ronald Reagan Pkwy",
            "city": "Avon",
            "state": "IN",
            "country_code": "US",
            "postal_code": "461237085",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "sbormann@direct.iuhealth.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1701 N Senate Blvd",
            "city": "Indianapolis",
            "state": "IN",
            "country_code": "US",
            "postal_code": "462021239",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Indianapolis, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 16, 2025; 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.