SHANNON SMITH (CRNA) – Certified Registered Nurse Anesthetist, NPI 1780652149

SHANNON SMITH (CRNA) is a healthcare provider. based in Royal oak, Michigan. specializing in CERTIFIED REGISTERED NURSE ANESTHETIST (CRNA). They hold the professional credentials CRNA. They hold a License No. 4704207026 (MI). The NPI Number for SHANNON SMITH (CRNA) is 1780652149

Main info

Female
22 Years Of Experience
Accepts Medicare Assignment
Name
SHANNON SMITH (CRNA)
NPI
1780652149
Phone
(248) 423-2481
Address
3601 W. 13 MILE RD
Enumeration Date
10 March 2006
Last Update Date
8 July 2007

Doctor Profile

Medical School Name
OAKLAND UNIV, WILLIAM BEAUMONT SCHOOL OF MEDICINE
Secondary Phone
2696517824
Graduation Year
2004 (22 years ago)
PAC ID
9335105998
Group Practice PAC ID
5395884621
Professional Enrollment ID
I20041206000311
Address ID
MI490912326ST916XXSTXX300
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience54
Completeness75
Years active:20State licenses:1Digital endpointsOther names

2,692 CERTIFIED REGISTERED NURSE ANESTHETIST (CRNA) in MI

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Provider Addresses for SHANNON SMITH (CRNA)

  • Beaumont Hospital - Royal Oak, 3601, West 13 Mile Road, Royal Oak, Oakland County, Michigan, 48073, United States

    400 FSC-PCS

    ROYAL OAK, MI 480736769

    Phone: (248) 423-2481

    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: 2004-12-06

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
I20041206000311ICertified Registered Nurse Anesthetist (Crna)MITBD

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.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 48073)

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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: 5395884621View full group profile
NameSpecialtyState
Emergency MedicineMI
Emergency MedicineMI
Physician AssistantMI
Family Practice, Emergency MedicineMI
Emergency MedicineMI
Certified Registered Nurse Anesthetist (Crna)MI
General SurgeryMI
Emergency MedicineMI

Reviews

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Frequently asked questions

How is SHANNON SMITH (CRNA) identified in CMS data?
CMS-hosted NPPES data lists SHANNON SMITH (CRNA) with NPI 1780652149.
Is SHANNON SMITH (CRNA) listed as active for patients and plans?
The listing shows SHANNON SMITH (CRNA) as active in the NPI system.
What taxonomy line describes SHANNON SMITH (CRNA)?
For research purposes, treat SHANNON SMITH (CRNA) as Certified Registered Nurse Anesthetist in this dataset. Clinical services aligned with this taxonomy classification.
What area does SHANNON SMITH (CRNA) serve?
SHANNON SMITH (CRNA)'s listing highlights Royal Oak, Michigan; more addresses can appear in NPPES.
What does 'Individual Provider' mean on this profile?
Entity type tells you whether the number belongs to a person or an organization.

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