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

Individual provider Certified Registered Nurse Anesthetist · NPI 1063137677

Shane Richard Smith, CRNA is a Certified Registered Nurse Anesthetist (CRNA) in Fairbanks, Alaska. Qualified in 2022, 4 years ago. Practices with Tanana Valley Clinic LLC, a 142-clinician group and accepts Medicare assignment. Licensed in Alaska.

Years since qualifying
4
Licensed in
AK
In the registry since
2022
What do these letters mean?
CRNA — Certified Registered Nurse Anesthetist
An advanced practice nurse who administers anaesthesia.

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Practice location Address checks out

1650 Cowles St
Fairbanks, AK 99701-5907
Phone: (907) 452-8181
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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 145179 (AK)

Record details

NPI number1063137677
Entity typeIndividual (Type 1)
GenderMale
Credentials CRNA
Sole proprietorYes
NPI enumeratedOctober 5, 2022
Last updated in NPPESOctober 5, 2022
Certification dateOctober 5, 2022
Mailing address2 N 3000 E, Sugar City, ID 83448-1220

Medicare enrollment

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

Medicare specialtyCERTIFIED REGISTERED NURSE ANESTHETIST (CRNA)
Medical schoolOTHER
Graduated 2022 (4 years in practice)
Group practice Tanana Valley Clinic Llc — 142 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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