Provider Demographics
NPI:1205932308
Name:SHAW-JONES, CARMETA DENISE (CRNA)
Entity type:Individual
Prefix:MRS
First Name:CARMETA
Middle Name:DENISE
Last Name:SHAW-JONES
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:EXCEL ANESTHESIA, LLC
Mailing Address - Street 2:13851 W. 63RD ST., SUITE 433
Mailing Address - City:SHAWNEE
Mailing Address - State:KS
Mailing Address - Zip Code:66216-3800
Mailing Address - Country:US
Mailing Address - Phone:813-721-3641
Mailing Address - Fax:913-721-3649
Practice Address - Street 1:EPIC EYE SURGERY CENTER, LLC
Practice Address - Street 2:11261 NALL AVENUE #200
Practice Address - City:LEAWOOD
Practice Address - State:KS
Practice Address - Zip Code:66211
Practice Address - Country:US
Practice Address - Phone:913-671-3290
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-15
Last Update Date:2025-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS43-54461-011367500000X
MO108387367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS100251390DMedicaid
MO1205932308Medicaid
MOS55000005Medicare PIN
MOJ11000007Medicare PIN
MO1205932308Medicaid