Shane Verl Theobald, CRNA
NPI 1174783492ActiveIndividual· Nurse Anesthetist, Certified Registered· Vernal, UT
Nurse Anesthetist, Certified Registered (CRNA) with Mountain View Anesthesia Lc, practicing in Vernal, Utah. Medicare paid $17,982 for services to 87 patients in 2024.
Overview
| NPI | 1174783492 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Credential | CRNA |
| Sole proprietor | No |
| NPI issued | Jun 10, 2008 |
| Last updated in NPPES | Jun 10, 2008 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Nurse Anesthetist, Certified Registered Primary | 367500000X | 4938276-4406 | UT |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Practitioner - Certified Registered Nurse Anesthetist (CRNA) (UT) |
|---|---|
| Accepts assignment | Yes (participating) |
Medicare services in 2024
| Medicare patients | 87 |
|---|---|
| Services billed | 90 across 28 procedure codes |
| Paid by Medicare | $17,982 |
Education and affiliations
| Graduation year | 2007 |
|---|---|
| Medicare specialty | Certified Registered Nurse Anesthetist (Crna) |
Medical group
- Mountain View Anesthesia LcDraper, UT · 31 clinicians
Industry payments (Open Payments)
None reported for 2025 or 2024.
Receiving payments does not imply wrongdoing. What Open Payments covers ·original records
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