Derek Shafer, RN

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

291860 Issued in OH

Practice address

3000 Mack Rd
Fairfield, OH 45014-5335

Phone

(513) 672-4128

Fax

(513) 672-3323

NPI assigned

Jul 7, 2006

Last updated

Jul 8, 2007By the provider in NPPES

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 OH

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Registered Nurse

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• New Albany Orthopedic Anesthesia LLC

  • Anesthesiology Physician
  • Columbus, OH
  • NPI 1093762635
  Medicare reassignment NPD
• Fairfield Anesthesia Consultants Inc

  • Anesthesiology Physician
  • Fairfield, OH
  • NPI 1871775387
  NPD (past)
• Orange ASC, LTD

  dba Orthopedic ONE Surgery Center at Easton

  • Ambulatory Surgical Clinic/Center
  • Columbus, OH
  • NPI 1619333010
  NPD (past)
• Perioperative Medical Consutants Inc

  • Anesthesiology Physician
  • Fairfield, OH
  • NPI 1124028162
  NPD (past)
• Universtiy Anesthesia Assoc., Inc.

  • Pain Medicine (Anesthesiology) Physician
  • Cincinnati, OH
  • NPI 1962455493
  NPD (past)

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

{
    "created_epoch": "1152230400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1952333171",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 NORTHLAND BLVD",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452463604",
            "telephone_number": "513-672-4128",
            "fax_number": "513-672-3323"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3000 MACK RD",
            "city": "FAIRFIELD",
            "state": "OH",
            "postal_code": "450145335",
            "telephone_number": "513-672-4128",
            "fax_number": "513-672-3323"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAFER",
        "first_name": "DEREK",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-07",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "OH",
            "license": "291860",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Servucare Home Care
• Seva Dental Ohio LLC
• Agnes N Sevume-Luswata, RN
• Jasmyne Marie Sexton
• Shadai Health Care LLC
• Emily Shaffer, PA-C
• Mohammad Nabeel Shah, APRN
• Deshannon Nicol Shearer
• Jennifer E Sheehy, M.A., CCC-SLP
• Emana Sheikh-Kapadia

• Certified Registered Nurse Anesthetist in Fairfield, OH
• Providers in Fairfield, OH by specialty
• Certified Registered Nurse Anesthetist in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.