Cole R Shawver, | |
1400 W 4th St, Coffeyville, KS 67337-3306 | |
(620) 251-1200 | |
Not Available |
Full Name | Cole R Shawver |
---|---|
Gender | Male |
Speciality | Certified Registered Nurse Anesthetist (crna) |
Experience | 8 Years |
Location | 1400 W 4th St, Coffeyville, Kansas |
Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
Identifier | Type | State | Issuer |
---|---|---|---|
1912300120 | NPI | - | NPPES |
2166074 | Medicaid | WA |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
367500000X | Nurse Anesthetist, Certified Registered | 154164 (Kansas) | Primary |
367500000X | Nurse Anesthetist, Certified Registered | AP61095990 (Washington) | Secondary |
Facility Name | Location | Facility Type |
---|---|---|
Saint Alphonsus Medical Center - Ontario, Inc | Ontario, OR | Hospital |
Group Practice Name | Group PECOS PAC ID | No. of Members |
---|---|---|
Treasure Valley Anesthesia Pc | 2365414497 | 5 |
St Anthony Hospital | 3678568268 | 15 |
Treasure Valley Anesthesia Pc | 2365414497 | 5 |
Entity Name | St Anthony Hospital |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1831169903 PECOS PAC ID: 3678568268 Enrollment ID: O20040414001635 |
Entity Name | Treasure Valley Anesthesia Pc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1215992003 PECOS PAC ID: 2365414497 Enrollment ID: O20040810000538 |
Mailing Address | Practice Location Address |
---|---|
Cole R Shawver, 1400 W 4th St, Coffeyville, KS 67337-3306 Ph: (620) 251-1200 | Cole R Shawver, 1400 W 4th St, Coffeyville, KS 67337-3306 Ph: (620) 251-1200 |
Larry D Phipps, CRNA Nurse Anesthetist - CR Medicare: Not Enrolled in Medicare Practice Location: 1400 W 4th St, Coffeyville, KS 67337 Phone: 620-252-1200 | |
Mrs. Julia Dawn Moses, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 1400 W 4th St, Coffeyville, KS 67337 Phone: 620-251-1200 | |
Mr. Logan Michael Bustos, CRNA Nurse Anesthetist - CR Medicare: Medicare Enrolled Practice Location: 101 S. Parkview St., Coffeyville, KS 67337 Phone: 620-252-8766 |