Shane Verl Theobald, CRNA | |
151 W 200 N, Vernal, UT 84078-1907 | |
(435) 781-1519 | |
(435) 781-1519 |
Full Name | Shane Verl Theobald |
---|---|
Gender | Male |
Speciality | Certified Registered Nurse Anesthetist (crna) |
Experience | 17 Years |
Location | 151 W 200 N, Vernal, Utah |
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 |
---|---|---|---|
1174783492 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
367500000X | Nurse Anesthetist, Certified Registered | 4938276-4406 (Utah) | Primary |
Facility Name | Location | Facility Type |
---|---|---|
Mountain View Hospital | Payson, UT | Hospital |
Timpanogos Regional Hospital | Orem, UT | Hospital |
Group Practice Name | Group PECOS PAC ID | No. of Members |
---|---|---|
Mountain View Anesthesia Lc | 5991604829 | 19 |
Entity Name | Mountain View Anesthesia Lc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1043249840 PECOS PAC ID: 5991604829 Enrollment ID: O20040108000626 |
Entity Name | Riverwoods Anesthesia Pllc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1821290883 PECOS PAC ID: 0547217366 Enrollment ID: O20050405000096 |
Entity Name | Mt Nebo Anesthesia Associates Llc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1053321729 PECOS PAC ID: 3577586932 Enrollment ID: O20060111000831 |
Entity Name | Sevier Valley Anesthesia Group Llp |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1487895462 PECOS PAC ID: 5991855389 Enrollment ID: O20090605000031 |
Mailing Address | Practice Location Address |
---|---|
Shane Verl Theobald, CRNA Po Box 790164, Vernal, UT 84079-0164 Ph: (435) 781-1519 | Shane Verl Theobald, CRNA 151 W 200 N, Vernal, UT 84078-1907 Ph: (435) 781-1519 |
Pauline Frome, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 3021 E 5000 S, Vernal, UT 84078 Phone: 435-790-1877 | |
Mr. Michael Arthur Hartman, Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 151 W 200 N, Vernal, UT 84078 Phone: 435-789-3352 Fax: 435-781-6893 | |
Mr. Dee Lewis Bambrough, CRNA Nurse Anesthetist - CR Medicare: Not Enrolled in Medicare Practice Location: 151 W 200 N, Vernal, UT 84078 Phone: 435-789-3342 Fax: 435-781-6893 | |
Edwin Bulloch, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 150 W 100 N, Vernal, UT 84078 Phone: 207-659-8810 | |
Dustin Todd Bradley, Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 808 W 300 N, Vernal, UT 84078 Phone: 435-828-2541 |