GRAYDEN J SHULL (CRNA) – Certified Registered Nurse Anesthetist, NPI 1902888191

GRAYDEN J SHULL (CRNA) is a healthcare provider. based in Marquette, Michigan. specializing in CERTIFIED REGISTERED NURSE ANESTHETIST (CRNA). They hold the professional credentials CRNA. They hold a License No. 4704230718 (MI). The NPI Number for GRAYDEN J SHULL (CRNA) is 1902888191

Main info

Male
21 Years Of Experience
Accepts Medicare Assignment
Name
GRAYDEN J SHULL (CRNA)
NPI
1902888191
Phone
(906) 225-3406
Address
580 W College Ave
Enumeration Date
15 November 2005
Last Update Date
19 April 2021

Doctor Profile

Medical School Name
OTHER
Secondary Phone
8084328800
Graduation Year
2005 (21 years ago)
PAC ID
3577589563
Group Practice PAC ID
1850205360
Professional Enrollment ID
I20180601001366
Address ID
HI968191469HO3288XRDXX300

Contacts

SOAP Endpoint
https://careepicwest.kp.org:14430/interconnect-prodhim/wcf/epic.community.hie/xcpdrespondinggateways
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience64
Completeness85
Years active:20State licenses:1Other namesUpdated within 12 months

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

Provider Addresses for GRAYDEN J SHULL (CRNA)

  • 580 W College Ave

    Marquette, MI 498552705

    Phone: (906) 225-3406

    Fax: (906) 225-3094

    Type: Location

  • Marquette General Hospital, 580, West College Avenue, Marquette, Marquette County, Michigan, 49855, United States

    MARQUETTE, MI 498552705

    Phone: (906) 225-3406

    Fax: (906) 225-3094

    Type: Location

  • 3288 MOANALUA RD

    HONOLULU, HI 968191469

    Phone: (808) 432-0000

    Type: Location

  • 2425 M 28 E

    MARQUETTE, MI 498559532

    Phone: (906) 343-6502

    Type: Mailing

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: 2018-06-01

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
I20180601001366ICertified Registered Nurse Anesthetist (Crna)HITBD

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 49855)

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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: 1850205360View full group profile
NameSpecialtyState
Nurse PractitionerHI
Nurse PractitionerHI
-HI
-HI
-CO
Clinical PsychologistHI
Clinical PsychologistHI
Certified Registered Nurse Anesthetist (Crna)WA
Nurse PractitionerHI
-HI

Reviews

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Frequently asked questions

Does GRAYDEN J SHULL (CRNA) have a public NPI I can cite?
Public records show GRAYDEN J SHULL (CRNA) under NPI 1902888191.
Should I treat GRAYDEN J SHULL (CRNA) as an active provider?
Patients and plans typically see GRAYDEN J SHULL (CRNA) as active in the national extract.
Which specialty label fits GRAYDEN J SHULL (CRNA)?
NPPES ties GRAYDEN J SHULL (CRNA) to Certified Registered Nurse Anesthetist in the taxonomy section. Clinical services aligned with this taxonomy classification.
What geographic area is tied to GRAYDEN J SHULL (CRNA)?
GRAYDEN J SHULL (CRNA) is associated with Marquette, Michigan in the same public data insurers reference.
Why is information missing for GRAYDEN J SHULL (CRNA)?
Providers choose how much contact data to publish. Missing fields do not mean the profile is fake.

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