DR. SHANE JAMISON (DNP) – Certified Registered Nurse Anesthetist, NPI 1083150064

DR. SHANE JAMISON (DNP) is a healthcare provider. based in Fort smith, Arkansas. specializing in CERTIFIED REGISTERED NURSE ANESTHETIST (CRNA). They hold the professional credentials DNP. They hold a License No. C003202 (AR). The NPI Number for DR. SHANE JAMISON (DNP) is 1083150064

Main info

Male
Sole Proprietor
9 Years Of Experience
Accepts Medicare Assignment
Name
DR. SHANE JAMISON (DNP)
NPI
1083150064
Phone
(918) 721-3264
Address
12809 DIAMOND LN
Enumeration Date
13 January 2017
Last Update Date
21 February 2020

Doctor Profile

Medical School Name
OTHER
Secondary Phone
4793146000
Graduation Year
2017 (9 years ago)
PAC ID
2062781719
Group Practice PAC ID
3173056298
Professional Enrollment ID
I20170712000612
Address ID
AR729034100FO7301XAVEX300
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience42
Completeness75
Years active:9State licenses:1Digital endpointsOther names

716 CERTIFIED REGISTERED NURSE ANESTHETIST (CRNA) in AR

Provider Addresses for DR. SHANE JAMISON (DNP)

  • 12809 DIAMOND LN

    FORT SMITH, AR 729164155

    Phone: (918) 721-3264

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2017-07-12

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20170712000612ICertified Registered Nurse Anesthetist (Crna)ARTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
00840Anesthesia for other procedure on lower abdomen1919$0
64450Injection of anesthetic agent and/or steroid into other nerve or branch1515$0
76942Ultrasonic guidance for needle placement1313$0
00910Anesthesia for other procedure on urinary system through urethra1111$0
01230Anesthesia for procedure on upper 2/3rd of thigh bone1111$0
View full utilization report →

Insurance plans in this area (ZIP 72916)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 3173056298View full group profile
NameSpecialtyState
Certified Registered Nurse Anesthetist (Crna)SC
Certified Registered Nurse Anesthetist (Crna)AR
Certified Registered Nurse Anesthetist (Crna)OK
Certified Registered Nurse Anesthetist (Crna)OK
Certified Registered Nurse Anesthetist (Crna)MO
A N E S T H E S I O L O G YAR
Certified Registered Nurse Anesthetist (Crna)AR
Certified Registered Nurse Anesthetist (Crna)AR
Certified Registered Nurse Anesthetist (Crna)AR
Certified Registered Nurse Anesthetist (Crna)AR

Reviews

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Frequently asked questions

Does DR. SHANE JAMISON (DNP) share an NPI with anyone else?
NPI numbers are unique to each provider or organization — DR. SHANE JAMISON (DNP) uses 1083150064.
Can I rely on DR. SHANE JAMISON (DNP) being an active provider?
As of the registry snapshot, DR. SHANE JAMISON (DNP) is marked active.
What healthcare role does DR. SHANE JAMISON (DNP) hold?
Scheduling teams often label DR. SHANE JAMISON (DNP) under Certified Registered Nurse Anesthetist. Clinical services aligned with this taxonomy classification.
Where should I expect DR. SHANE JAMISON (DNP) on a map?
Expect Fort Smith, Arkansas as a primary anchor for DR. SHANE JAMISON (DNP) unless the record lists multiple sites.
Is the information about DR. SHANE JAMISON (DNP) up to date?
Data updates when providers file changes in NPPES — treat critical facts as "verify if unsure."

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