Individual provider Active NPI

Jane Shaw, CRNA

  • Certified Registered Nurse Anesthetist
  • Saint Joseph, MI
National Provider Identifier
1972169688
Registry record updated May 17, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
4704157839 Issued in MI
Practice address
1234 Napier Ave
Saint Joseph, MI 49085-2112
Phone
(334) 279-1450
Fax
(334) 279-1660
NPI assigned
May 17, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 17, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 4704157839 MI Primary

Addresses

Primary practice location

1234 Napier Ave
Saint Joseph, MI 49085-2112

Mailing address

PO Box 633020
Cincinnati, OH 45263-3020
Phone (334) 279-1450

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI, IN2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20190702002930 MI Practitioner - Certified Registered Nurse Anesthetist (Crna) 8527392042 Reassigns benefits to 1 organization
I20230228000980 IN Practitioner - Certified Registered Nurse Anesthetist (Crna) 8527392042 Reassigns benefits to 2 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Lakeland Hospitals at Niles and St Joseph, Inc CurrentSince Jan 1, 2020 Accepting new patients
Lakeland Hospitals at Niles and St Joseph, Inc Nurse Anesthetist, Certified Registered CurrentSince Jan 1, 2020 Accepting new patients
Lakeland Hospitals at Niles and St Joseph, Inc Current Accepting new patients
Northern Indiana Anesthesia Associates, LLC Nurse Anesthetist, Certified Registered CurrentSince Dec 23, 2025 Accepting new patients
Allied Physicians Surgery Center, LLC Past Accepting new patients

Locations

53830 Generations Dr
South Bend, IN 46635
Phone (574) 217-0174

1234 Napier Ave
Saint Joseph, MI 49085
Phone (269) 982-4941

1234 Napier Ave
#32
Saint Joseph, MI 49085
Phone (269) 428-0118

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1558051200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1558051200000",
    "number": "1972169688",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 633020",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452633020",
            "telephone_number": "334-279-1450",
            "fax_number": "334-279-1660"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1234 NAPIER AVE",
            "city": "SAINT JOSEPH",
            "state": "MI",
            "postal_code": "490852112",
            "telephone_number": "334-279-1450",
            "fax_number": "334-279-1660"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAW",
        "first_name": "JANE",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-05-17",
        "last_updated": "2019-05-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MI",
            "license": "4704157839",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Joseph, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 17, 2019; 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.