DOROTHY LORRAINE SHACKLEFORD (NPI# 1003888447) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1003888447 |
| Entity Type | Individual |
| Full Name | DOROTHY LORRAINE SHACKLEFORD |
| Practice Address |
3963 Hartlake St Woodbridge VA 22192-7477 |
| Mailing Address |
68 South Service Road Suite 350 Melville NY 11545-2358 |
| Practice Telephone | 7035902019 |
| Mailing Telephone | 5169453000 |
| Mailing Fax Number | 5169453131 |
| Enumeration Date | 2006-02-01 |
| Last Update Date | 2015-04-23 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 367500000X | Nurse Anesthetist, Certified Registered | 0001212718 | VA | Physician Assistants & Advanced Practice Nursing Providers |
| N | 367500000X | Nurse Anesthetist, Certified Registered | 598148 | CA | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| VA | RAILROAD MEDICARE | P01179302 | 01 |
| VA | 1003888447 | 05 |
| Street Address |
3963 HARTLAKE ST |
| City | WOODBRIDGE |
| State | VA |
| Zip Code | 22192-7477 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245873645 | Ursula Jackson | Technician | 3500 Commission Ct, Woodbridge, VA 22192 | 2019-10-18 |
| 1205480779 | Ki Soo Park | Physical Therapy Assistant | 12825 Minnieville Road Suite 201, Lake Ridge, VA 22192 | 2019-08-01 |
| 1801448329 | Karen Lee Trivett | Specialist/Technologist, Other | 12584 Darby Brook Court, Woodbridge, VA 22192 | 2019-07-15 |
| 1407313166 | Nichele Amelia Thompson | Behavioral Analyst | 2731 Marblestone Dr, 101, Woodbridge, VA 22192 | 2019-02-28 |
| 1952877870 | Kimberly Ann Rojas Vazquez | Behavioral Analyst | 12531 Clipper Dr, Suite 203, Woodbridge, VA 22192 | 2018-10-18 |
| 1104391614 | Ykim Dental | Dentist | 2680 Optiz Blvd., Suite 120, Woodbridge, VA 22192 | 2018-10-11 |
| 1013418755 | Arm Transport | Non-emergency Medical Transport (VAN) | 13000 Harbor Center Dr Ste 132d, Woodbridge, VA 22192 | 2018-02-27 |
| 1811496813 | Francesca Nasi | Behavioral Analyst | 12531 Clipper Dr Ste 203, Woodbridge, VA 22192 | 2018-02-05 |
| 1942729504 | Bismark Transportation Service LLC | Non-emergency Medical Transport (VAN) | 12341 Woodlawn Court, Woodbridge, VA 22192 | 2017-09-14 |
| 1992226344 | Arm Baby Eldery Home Health LLC | Home Health | 13000 Harbor Center Dr # 312c, Woodbridge, VA 22192 | 2017-07-06 |
| Find all providers in zip 22192 | ||||
| Taxonomy Code | 367500000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Anesthetist, Certified Registered |
| (1) A licensed registered nurse with advanced specialty education in anesthesia who, in collaboration with appropriate health care professionals, provides preoperative, intraoperative, and postoperative care to patients and assists in management and resuscitation of critical patients in intensive care, coronary care, and emergency situations. Nurse anesthetists are certified following successful completion of credentials and state licensure review and a national examination directed by the Council on Certification of Nurse Anesthetists. (2) A registered nurse who is qualified by special training to administer anesthesia in collaboration with a physician or dentist and who can assist in the care of patients who are in critical condition. |
| Notes: Sources: (1) Council on Certification of Nurse Anesthetists, Park Ridge, IL, and Rhea, Ott, and Shafritz, The Facts On File Dictionary of Health Care Management, New York: Facts On File Publications, 1988. (2) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, The Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, Illinois: 1994, p. 548. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487977724 | Azucena Gault | Nurse Anesthetist, Certified Registered | 2300 Opitz Blvd., Woodbridge, VA 22191 | 2010-03-01 |
| 1326018474 | Steven Paul Kelsch | Nurse Anesthetist, Certified Registered | 2300 Opiz Blvd., Woodbridge, VA 22191-3398 | 2006-01-23 |
| 1255986147 | Premier Anesthesia of Virginia LLC | Nurse Anesthetist, Certified Registered | 2300 Opitz Blvd, Woodbridge, VA 22191-3311 | 2019-08-07 |
| 1245704022 | Claire Caine | Nurse Anesthetist, Certified Registered | 2300 Opitz Blvd, Woodbridge, VA 22191-3311 | 2019-01-15 |
| 1396246732 | Chayamorn Leeraksakiat | Nurse Anesthetist, Certified Registered | 2300 Opitz Blvd, Woodbridge, VA 22191 | 2018-02-21 |
| 1386151587 | Libby Oldenburg | Nurse Anesthetist, Certified Registered | 2300 Opitz Blvd, Woodbridge, VA 22191-3311 | 2018-01-09 |
| 1679099196 | Marium Laiq | Nurse Anesthetist, Certified Registered | 2300 Opitz Blvd, Woodbridge, VA 22191-3311 | 2017-08-16 |
| 1992242697 | Lan Nguyen | Nurse Anesthetist, Certified Registered | 2300 Opitz Blvd, Woodbridge, VA 22191-3311 | 2017-01-19 |
| 1508223504 | Ryan Kauffman | Nurse Anesthetist, Certified Registered | 2300 Opitz Blvd, Woodbridge, VA 22191-3311 | 2016-01-21 |
| 1477942001 | Patricia May Morrissey | Nurse Anesthetist, Certified Registered | 2300 Opitz Blvd, Woodbridge, VA 22191-3311 | 2015-01-20 |
| Find all providers in WOODBRIDGE | ||||
| City | WOODBRIDGE |
| Zip Code | 22192 |
Please comment or provide details below to improve the information on DOROTHY LORRAINE SHACKLEFORD.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.