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

Miss. Shea Randi Clark

Individual provider Certified Registered Nurse Anesthetist · NPI 1043882764

Miss. Shea Randi Clark is a Certified Registered Nurse Anesthetist (CRNA) in Charlotte, North Carolina. Qualified in 2021, 5 years ago. Practices with Chs Anesthesia Services Group Inc, a 737-clinician group and accepts Medicare assignment. Licensed in North Carolina.

Years since qualifying
5
Licensed in
NC
In the registry since
2021
Specialties on file
2
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Practice location Address checks out

1000 Blythe Blvd
Charlotte, NC 28203-5812
Phone: (704) 355-2000
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Certified Registered Nurse Anesthetist (primary) Taxonomy 367500000X · Licence 138248 (NC)
Registered Nurse Taxonomy 163W00000X · Licence 270821 (NC)

Record details

NPI number1043882764
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedJuly 13, 2021
Last updated in NPPESFebruary 14, 2022
Certification dateFebruary 14, 2022

Medicare enrollment

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

Medicare specialtyCERTIFIED REGISTERED NURSE ANESTHETIST (CRNA)
Medical schoolOTHER
Graduated 2021 (5 years in practice)
Group practice Chs Anesthesia Services Group Inc — 737 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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