Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Kelly Ray Shantz, CRNA

Individual provider Certified Registered Nurse Anesthetist · NPI 1477540995

Kelly Ray Shantz, CRNA is a Certified Registered Nurse Anesthetist (CRNA) in Fairmont, Minnesota. Qualified in 2001, 25 years ago. Practices with Mayo Clinic Health System-Southeast Minnesota Region, a 561-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in Minnesota.

Years since qualifying
25
Licensed in
MN
In the registry since
2005
Specialties on file
2
What do these letters mean?
CRNA — Certified Registered Nurse Anesthetist
An advanced practice nurse who administers anaesthesia.

See every abbreviation used in this directory →

Practice location Address checks out

800 Medical Center Dr
Fairmont, MN 56031-4575
Phone: (507) 238-8555
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 805 Johnson St, Fairmont, MN 56031-4523 — (507) 238-8100

Specialties & licences

Certified Registered Nurse Anesthetist (primary) Taxonomy 367500000X · Licence 868 (MN)
Certified Registered Nurse Anesthetist Taxonomy 367500000X · Licence R 162289-8 (MN)

Record details

NPI number1477540995
Entity typeIndividual (Type 1)
GenderMale
Credentials CRNA
Sole proprietorNo
NPI enumeratedSeptember 29, 2005
Last updated in NPPESSeptember 17, 2020
Certification dateSeptember 17, 2020

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyCERTIFIED REGISTERED NURSE ANESTHETIST (CRNA)
Medical schoolOTHER
Graduated 2001 (25 years in practice)
Group practice Mayo Clinic Health System-Southeast Minnesota Region — 561 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations3 on file with Medicare

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