MR. KELLY SHAUN SIMPSON (CRNA) – Certified Registered Nurse Anesthetist, NPI 1497732903
Certified Registered Nurse Anesthetist
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
987 CERTIFIED REGISTERED NURSE ANESTHETIST (CRNA) in WA
Provider Addresses for MR. KELLY SHAUN SIMPSON (CRNA)
1642 PARKSIDE CIR
NICEVILLE, FL 325788706
Phone: (850) 830-5525
Type: Mailing
MADIGAN ARMY MEDICAL CENTER ATTN: CREDENTIALS OFFICE
9040 JACKSON AVE
TACOMA, WA 98431
Phone: (253) 969-2252
Fax: (235) 968-3278
Type: Location
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: 2024-07-02
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking 2 Medicare enrollment records; no due dates published yet.
Enrollment records
2
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20230426001965 | I | Certified Registered Nurse Anesthetist (Crna) | WA | TBD |
| I20240702003203 | I | Certified Registered Nurse Anesthetist (Crna) | OR | TBD |
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.
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.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 32578)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| A N E S T H E S I O L O G Y | WA | |
| - | WA | |
| A N E S T H E S I O L O G Y | WA | |
| A N E S T H E S I O L O G Y | WA | |
| A N E S T H E S I O L O G Y | WA | |
| A N E S T H E S I O L O G Y | WA | |
| - | WI | |
| Certified Registered Nurse Anesthetist (Crna) | WA | |
| Certified Registered Nurse Anesthetist (Crna) | WA | |
| A N E S T H E S I O L O G Y | WA |
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