Shane Connor O'Neill, CRNA

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

4704311144 Issued in MI

Practice address

205 N East Ave
Jackson, MI 49201-1753

Phone

(517) 205-4800

NPI assigned

Jan 6, 2021

Sex

Male

Sole proprietor

No

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 MI

Enrollment records 1

Specialty

Certified Registered Nurse Anesthetist (Crna)

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

W. a. Foote Memorial Hospital, Inc.Group PAC ID 0244136067, 476 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Henry Ford Allegiance Health Hospital, Jackson, MI, CCN 230092

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Registered Nurse

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: soneill715670@direct.hfhs.org

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.

• Wa Foote Memorial Hospital, Inc

  • Certified Registered Nurse Anesthetist
  • Jackson, MI
  • NPI 1598776718

  Nurse Anesthetist, Certified Registered

  Medicare reassignment Care Compare group NPD
• W.a. Foote Memorial Hospital, Inc

  • Physician Assistant
  • Jackson, MI
  • NPI 1538606348
  NPD

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

• W.a. Foote Memorial Hospital

  • General Acute Care Hospital
  • Jackson, MI
  • NPI 1053403402
  Care Compare affiliation

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

{
    "created_epoch": "1609891200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1609891200000",
    "number": "1912595810",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "130 HELLE BLVD APT 603",
            "city": "DUNDEE",
            "state": "MI",
            "postal_code": "481318404",
            "telephone_number": "248-504-7075"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "205 N EAST AVE",
            "city": "JACKSON",
            "state": "MI",
            "postal_code": "492011753",
            "telephone_number": "517-205-4800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "O'NEILL",
        "first_name": "SHANE",
        "middle_name": "CONNOR",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-01-06",
        "last_updated": "2021-01-06",
        "certification_date": "2021-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MI",
            "license": "4704311144",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jesse O'Dell, DP-ADC
• Casey Alexander O'Doherty, DO
• Sadie O'Dowd, M.S. CF-SLP
• Donna M O'Neill, MD
• Kristen A. O'Neill, MSW
• Austin Michael Oberlander, CNA
• Hannah Nichole Oberst, NP
• Obhg Michigan, PC
• Shawn Obi, DO
• Jason Obits, LLMSW

• Certified Registered Nurse Anesthetist in Jackson, MI
• Providers in Jackson, MI by specialty
• Certified Registered Nurse Anesthetist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 2021; 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.