| Scott K Shaffer, | |
|
448 E 1st St, Salida, CO 81201-2804 | |
| (719) 539-6661 | |
| Not Available |
| Full Name | Scott K Shaffer |
|---|---|
| Gender | Male |
| Speciality | Nurse Anesthetist, Certified Registered |
| Location | 448 E 1st St, Salida, Colorado |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1881626562 | NPI | - | NPPES |
| 59338547 | Medicaid | CO |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 367500000X | Nurse Anesthetist, Certified Registered | 165807 (Colorado) | Primary |
| Entity Name | Stratus Dominion Anesthesia Associates Pllc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1912350976 PECOS PAC ID: 8123313186 Enrollment ID: O20160830000965 |
| Entity Name | Hill Regional Physician Group Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1679189856 PECOS PAC ID: 6002220464 Enrollment ID: O20210126000758 |
| Mailing Address | Practice Location Address |
|---|---|
| Scott K Shaffer, 3863 Sw Loop 820, Suite 300, Fort Worth, TX 76133-2064 Ph: (877) 294-7444 | Scott K Shaffer, 448 E 1st St, Salida, CO 81201-2804 Ph: (719) 539-6661 |
Mr. Christopher Oudekerk, CRNA Nurse Anesthetist - CR Medicare: Medicare Enrolled Practice Location: 11830 Rangeview Cir, Salida, CO 81201 Phone: 252-622-8289 | |
Mrs. Jonelle Lynae Vallier, RN Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 1001 Rush Drive, Salida, CO 81291 Phone: 719-290-1367 | |
Mr. Lawrence M. Shovelton, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 29 Silver Spruce Dr, Salida, CO 81201 Phone: 719-325-6871 |