SHALETRA JORDAN – Certified Registered Nurse Anesthetist, NPI 1699164285

SHALETRA JORDAN is a healthcare provider. based in Carthage, Texas. specializing in CERTIFIED REGISTERED NURSE ANESTHETIST (CRNA). They hold a License No. AP127172 (TX). The NPI Number for SHALETRA JORDAN is 1699164285

Main info

Female
Sole Proprietor
12 Years Of Experience
Accepts Medicare Assignment
Name
SHALETRA JORDAN
NPI
1699164285
Phone
(903) 742-0197
Address
412 OVERLAND ST
Enumeration Date
20 January 2015
Last Update Date
20 January 2015

Doctor Profile

Medical School Name
OTHER
Secondary Phone
7139487000
Graduation Year
2014 (12 years ago)
PAC ID
2062739832
Group Practice PAC ID
1355606641
Professional Enrollment ID
I20150317000382
Address ID
TX775053948PA4600XSXXX618
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience36
Completeness75
Years active:11State licenses:1Digital endpointsOther names

5,281 CERTIFIED REGISTERED NURSE ANESTHETIST (CRNA) in TX

Provider Addresses for SHALETRA JORDAN

  • 412 OVERLAND ST

    CARTHAGE, TX 756331820

    Phone: (903) 742-0197

    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: 2015-03-17

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
I20150317000382ICertified Registered Nurse Anesthetist (Crna)TXTBD

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
01844Anesthesia for placement or revision of blood flow shunt7164$0
00811Anesthesia for other procedure on large bowel using an endoscope2929$0
00813Anesthesia for procedure on small and large bowel using an endoscope2525$0
01916Anesthesia for x-ray exam of arteries and veins using contrast1514$0
00731Anesthesia for other procedure on esophagus, stomach, or upper small bowel using an endoscope1212$0
View full utilization report →

Insurance plans in this area (ZIP 75633)

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Provider's Procedures

SHALETRA JORDAN performs procedures in CERTIFIED REGISTERED NURSE ANESTHETIST (CRNA). See the list of HCPCS codes below.
SpecialtyPractice State
HCPCS Code
Description
Service Count
Beneficiary Count
CERTIFIED REGISTERED NURSE ANESTHETTX00142Anesthesia for lens surgery2525

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: 1355606641View full group profile
NameSpecialtyState
Certified Registered Nurse Anesthetist (Crna)TX
-GA
Certified Registered Nurse Anesthetist (Crna)LA
Certified Registered Nurse Anesthetist (Crna)TX
Anesthesiology, Interventional Pain ManagementTX
Certified Registered Nurse Anesthetist (Crna)TX
Certified Registered Nurse Anesthetist (Crna)TX
Certified Registered Nurse Anesthetist (Crna)TX
Certified Registered Nurse Anesthetist (Crna)MS
Certified Registered Nurse Anesthetist (Crna)TX

Reviews

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Frequently asked questions

What is the 10-digit NPI for SHALETRA JORDAN?
SHALETRA JORDAN — NPI 1699164285 — is the standard way to identify this listing.
Can I rely on SHALETRA JORDAN being an active provider?
As of the registry snapshot, SHALETRA JORDAN is marked active.
What healthcare role does SHALETRA JORDAN hold?
Scheduling teams often label SHALETRA JORDAN under Certified Registered Nurse Anesthetist. Clinical services aligned with this taxonomy classification.
What address line appears for SHALETRA JORDAN?
SHALETRA JORDAN's geographic hint is Carthage, Texas in our summary view.
Why does SHALETRA JORDAN have multiple addresses?
2 practice locations appear in the available data. Multiple addresses are common for hospital privileges, telehealth, or multi-site groups.

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