SHANNON BEVILLE (CRNA) – Certified Registered Nurse Anesthetist, NPI 1053710780

SHANNON BEVILLE (CRNA) is a healthcare provider. based in Tulsa, Oklahoma. specializing in CERTIFIED REGISTERED NURSE ANESTHETIST (CRNA). They hold the professional credentials CRNA. They hold a License No. RNA233014 (ME). The NPI Number for SHANNON BEVILLE (CRNA) is 1053710780

Main info

Female
Sole Proprietor
12 Years Of Experience
Name
SHANNON BEVILLE (CRNA)
NPI
1053710780
Phone
(918) 494-0612
Address
6839 S CANTON AVE
Enumeration Date
19 August 2014
Last Update Date
19 March 2025

Doctor Profile

Medical School Name
OTHER
Secondary Phone
-
Graduation Year
2014 (12 years ago)
PAC ID
9032330303
Professional Enrollment ID
I20250206001306
Address ID
OK741363402TU6839XAVEX400
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience68
Completeness75
Years active:11State licenses:4Digital endpointsOther names

669 CERTIFIED REGISTERED NURSE ANESTHETIST (CRNA) in OK

Provider Addresses for SHANNON BEVILLE (CRNA)

  • 6839 S CANTON AVE

    TULSA, OK 741363402

    Phone: (918) 494-0612

    Fax: (918) 481-5170

    Type: Mailing

  • 6161 S YALE AVE

    TULSA, OK 741361902

    Phone: (918) 494-0612

    Type: Location

  • P.O. BOX 845347

    DALLAS, TX 752845347

    Phone: (214) 645-0624

    Fax: (214) 645-0078

    Type: Mailing

  • 5323 HARRY HINES BLVD

    DALLAS, TX 75390

    Phone: (214) 645-0624

    Fax: (214) 645-0078

    Type: Location

  • 5323 harry hines blvd

    Dallas, TX 75390

    Phone: (214) 645-0624

    Fax: (214) 645-0078

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 6 Open Payments records for all available years, with a total value of $110.

Total Amount is formed as General ($110) + Research ($0) + Ownership ($0) = $110.

Last reported payment date: 2024-12-03 • Largest payer in this snapshot: Merck Sharp & Dohme LLC ($110).

Total Amount

$110

General + Research + Ownership

Payments

6

Total payment records

General Amount

$110

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-12-03

Latest reported date

Top Companies

Largest payers in this snapshot

CompanyAmount
Merck Sharp & Dohme LLC$110
View all Open Payments →|Open Payments Risk Radar →

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: 2025-02-06

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

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

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20141030000672ICertified Registered Nurse Anesthetist (Crna)TXTBD
I20250206001306ICertified Registered Nurse Anesthetist (Crna)OKTBD

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
00731Anesthesia for other procedure on esophagus, stomach, or upper small bowel using an endoscope1616$0
View full utilization report →

Insurance plans in this area (ZIP 74136)

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Reviews

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Frequently asked questions

What federal number belongs to SHANNON BEVILLE (CRNA)?
The federal identifier for SHANNON BEVILLE (CRNA) is NPI 1053710780.
Does this profile mean SHANNON BEVILLE (CRNA) is currently active?
Yes — SHANNON BEVILLE (CRNA) appears active in the national provider directory.
What kind of provider is SHANNON BEVILLE (CRNA)?
The page reflects Certified Registered Nurse Anesthetist for SHANNON BEVILLE (CRNA). Clinical services aligned with this taxonomy classification.
What location shows for SHANNON BEVILLE (CRNA)?
We surface Tulsa, Oklahoma for SHANNON BEVILLE (CRNA) based on available NPPES addresses.
Is SHANNON BEVILLE (CRNA) a real provider?
This page reflects official NPPES data for NPI 1053710780. Always confirm identity and privileges with the practice and licensing boards.

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