| 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 | 9 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 |
| 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: Accepting Medicare Assignments Practice Location: 101 S. Parkview St., Coffeyville, KS 67337 Phone: 620-252-8766 |