Ms Nicole Genevieve Shadwick, CRNA - Medicare Certified Registered Nurse Anesthetist (crna) in Lake Havasu City, AZ

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Ms Nicole Genevieve Shadwick, CRNA is a medicare enrolled "Nurse Anesthetist, Certified Registered" in Lake Havasu City, Arizona. She graduated from nursing school in 2020 and has 5 years of diverse experience with area of expertise as Certified Registered Nurse Anesthetist (crna). She is a member of the group practice Valley Regional Anesthesia Associates Inc, Valley Regional Anesthesia Associates Inc and her current practice location is 101 Civic Center Ln, Lake Havasu City, Arizona. You can reach out to her office (for appointments etc.) via phone at (928) 855-8185.

Ms Nicole Genevieve Shadwick is licensed to practice in Texas (license number 1026890) 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 1447857552.

Contact Information

Ms Nicole Genevieve Shadwick, CRNA
101 Civic Center Ln,
Lake Havasu City, AZ 86403-5607
(928) 855-8185
(928) 453-0453

Map and Direction




Provider's Profile

Full NameMs Nicole Genevieve Shadwick
GenderFemale
SpecialityCertified Registered Nurse Anesthetist (crna)
Experience5 Years
Location101 Civic Center Ln, Lake Havasu City, Arizona
Accepts Medicare AssignmentsYes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance.
  Medical Education and Training:
  • Ms Nicole Genevieve Shadwick graduated from nursing school in 2020
  NPI Data:
  • NPI Number: 1447857552
  • Provider Enumeration Date: 10/02/2020
  • Last Update Date: 09/08/2025
  Medicare PECOS Information:
  • PECOS PAC ID: 1850708447
  • Enrollment ID: I20231011003920

Medical Identifiers

Medical identifiers for Ms Nicole Genevieve Shadwick such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1447857552NPI-NPPES
910112970MedicaidMO

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
367500000XNurse Anesthetist, Certified Registered 95002021 (California)Secondary
367500000XNurse Anesthetist, Certified Registered APRN11022686 (Florida)Secondary
367500000XNurse Anesthetist, Certified Registered 2022021771 (Missouri)Secondary
367500000XNurse Anesthetist, Certified Registered 1026890 (Texas)Primary

Medical Facilities Affiliation

Facility NameLocationFacility Type
Doctors Medical CenterModesto, CAHospital
Havasu Regional Medical CenterLake havasu city, AZHospital

Group Practice Association

Group Practice NameGroup PECOS PAC IDNo. of Members
Valley Regional Anesthesia Associates Inc3870964323152
Valley Regional Anesthesia Associates Inc3870964323152

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. Ms Nicole Genevieve Shadwick allows following entities to bill medicare on her behalf.
Entity NameAdvanced Anesthesia Incorporated
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1720543762
PECOS PAC ID: 4880936145
Enrollment ID: O20190507001500
Entity NameValley Regional Anesthesia Associates Inc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1578272415
PECOS PAC ID: 3870964323
Enrollment ID: O20230120001928

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. Ms Nicole Genevieve Shadwick 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 AddressPractice Location Address
Ms Nicole Genevieve Shadwick, CRNA
660 S Euclid Ave, Cb 8054,
Saint Louis, MO 63110-1010

Ph: (800) 862-9980		Ms Nicole Genevieve Shadwick, CRNA
101 Civic Center Ln,
Lake Havasu City, AZ 86403-5607

Ph: (928) 855-8185

Reviews and Comments


Nurse Anesthetist, Certified Registered Nurses in Lake Havasu City, AZ

Maria Fuller, CRNA
Nurse Anesthetist - CR
Medicare: Accepting Medicare Assignments
Practice Location: 2795 Poseidon Dr, Lake Havasu City, AZ 86404
Phone: 816-769-5775    
Ramon R Orduno Jr., CRNA
Nurse Anesthetist - CR
Medicare: Accepting Medicare Assignments
Practice Location: 101 Civic Center Ln, Lake Havasu City, AZ 86403
Phone: 928-855-8185    
Jessica Mortola, DNP CRNA
Nurse Anesthetist - CR
Medicare: Accepting Medicare Assignments
Practice Location: 101 Civic Center Ln, Lake Havasu City, AZ 86403
Phone: 928-855-8185    
Allison Nicole Fuller,
Nurse Anesthetist - CR
Medicare: Not Enrolled in Medicare
Practice Location: 101 Civic Center Ln, Lake Havasu City, AZ 86403
Phone: 928-855-8185    
Tawab Noori,
Nurse Anesthetist - CR
Medicare: Accepting Medicare Assignments
Practice Location: 101 Civic Center Ln, Lake Havasu City, AZ 86403
Phone: 928-855-8185    
Grayson Fleming Mchargue, CRNA
Nurse Anesthetist - CR
Medicare: Accepting Medicare Assignments
Practice Location: 101 Civic Center Ln, Lake Havasu City, AZ 86403
Phone: 928-855-8185    

Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

NPI Number: The National Provider Identifier (NPI) is a unique identification number for covered health care providers. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions. Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under HIPAA (Health Insurance Portability and Accountability Act).

Our Data: Information on www.medicarelist.com is built using data sources published by Centers for Medicare & Medicaid Services (CMS) under Freedom of Information Act (FOIA). The information disclosed on the NPI Registry are FOIA-disclosable and are required to be disclosed under the FOIA and the eFOIA amendments to the FOIA. There is no way to 'opt out' or 'suppress' the NPPES record data for health care providers with active NPIs.