Canaan Marie Champion, CRNA is a medicare enrolled "Nurse Anesthetist, Certified Registered" in Shattuck, Oklahoma. She graduated from nursing school in 2006 and has 18 years of diverse experience with area of expertise as Certified Registered Nurse Anesthetist (crna). She is a member of the group practice Jackson County Memorial Hospital Authority and her current practice location is
1523 S Main St, Shattuck, Oklahoma. You can reach out to her office (for appointments etc.) via phone at
(870) 403-1225.
Canaan Marie Champion is licensed to practice in Arkansas (license number C02654 CRNA) and she also participates in the medicare program. She
accepts medicare assignments (which means she accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and her NPI Number is 1922155001.
Provider's Profile
| Full Name | Canaan Marie Champion |
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| Gender | Female |
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| Speciality | Certified Registered Nurse Anesthetist (crna) |
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| Experience | 18 Years |
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| Location | 1523 S Main St, Shattuck, Oklahoma |
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| Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
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Medical Education and Training:
- Canaan Marie Champion graduated from nursing school in 2006
NPI Data:
- NPI Number: 1922155001
- Provider Enumeration Date: 01/04/2007
- Last Update Date: 10/30/2019
Medicare PECOS Information:
- PECOS PAC ID: 4688760960
- Enrollment ID: I20090914000743
Medical Identifiers
Medical identifiers for Canaan Marie Champion such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1922155001 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 367500000X | Nurse Anesthetist, Certified Registered | R 92363 (Oklahoma) | Secondary |
| 367500000X | Nurse Anesthetist, Certified Registered | RN164615 (Georgia) | Secondary |
| 367500000X | Nurse Anesthetist, Certified Registered | C02654 CRNA (Arkansas) | Primary |
Medical Facilities Affiliation
Group Practice Association
| Group Practice Name | Group PECOS PAC ID | No. of Members |
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| Jackson County Memorial Hospital Authority | 1759293178 | 54 |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Canaan Marie Champion allows following entities to bill medicare on her behalf.
| Entity Name | Jackson County Memorial Hospital Authority |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1093763781
PECOS PAC ID: 1759293178
Enrollment ID: O20031104000406 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Canaan Marie Champion is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
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Canaan Marie Champion, CRNA
2719 Highway 351,
Jonesboro, AR 72405-6931
Ph: (870) 403-1225 | Canaan Marie Champion, CRNA
1523 S Main St,
Shattuck, OK 73858-9223
Ph: (870) 403-1225 |
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