Shane Harrison, CRNA is a medicare enrolled "Nurse Anesthetist, Certified Registered" in Fillmore, Utah. His current practice location is
674 S Highway 99, Fillmore, Utah. You can reach out to his office (for appointments etc.) via phone at
(435) 743-5591.
Shane Harrison is licensed to practice in Utah (license number 2776204406) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1265519748.
Provider's Profile
| Full Name | Shane Harrison |
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| Gender | Male |
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| Speciality | Nurse Anesthetist, Certified Registered |
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| Location | 674 S Highway 99, Fillmore, Utah |
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| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
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NPI Data:
- NPI Number: 1265519748
- Provider Enumeration Date: 11/01/2006
- Last Update Date: 02/21/2012
Medicare PECOS Information:
- PECOS PAC ID: 9931101128
- Enrollment ID: I20070131000496
Medical Identifiers
Medical identifiers for Shane Harrison such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1265519748 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 367500000X | Nurse Anesthetist, Certified Registered | 2776204406 (Utah) | Primary |
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. Shane Harrison allows following entities to bill medicare on his behalf.
| Entity Name | Ihc Health Services Inc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1629260880
PECOS PAC ID: 1850209420
Enrollment ID: O20031105000079 |
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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. Shane Harrison 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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Shane Harrison, CRNA
Po Box 30180,
Salt Lake City, UT 84130-0180
Ph: () - | Shane Harrison, CRNA
674 S Highway 99,
Fillmore, UT 84631-5013
Ph: (435) 743-5591 |
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