Individual provider Active NPI

Thomas Scruggs, CRNA

  • Certified Registered Nurse Anesthetist
  • Missoula, MT
National Provider Identifier
1003847104
Registry record updated Oct 7, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
101158 Issued in MT
Practice address
1930 W Broadway St Ste a
Missoula, MT 59808-1960
Phone
(406) 541-6844
Fax
(406) 541-6843
NPI assigned
Jul 6, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 7, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 101158 MT Primary
Certified Registered Nurse Anesthetist 367500000X N-30039 ID

Addresses

Primary practice location

1930 W Broadway St Ste a
Missoula, MT 59808-1960

Mailing address

1930 W Broadway St Ste a
Missoula, MT 59808-1960
Phone (406) 541-6844

Other practice location 1

450 E Main St
Rexburg, ID 83440-2048
Phone (208) 356-3691

Other identifiers 1

IdentifierTypeStateIssuer
805979900MedicaidID

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MT

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20121123000010 MT Practitioner - Certified Registered Nurse Anesthetist (Crna) 5395872345 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
90.28 of 100Reported as group
Quality
94
Promoting interoperability
100
Improvement activities
40
Cost
73.6

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
N-30039IDMDCertified Registered Nurse Anesthetist
101158MTMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Northern Montana Hospital Current Accepting new patients
Northern Montana Hospital CurrentSince Nov 29, 2017 Accepting new patients
Northstar Anesthesia of Montana Nurse Anesthetist, Certified Registered CurrentSince Apr 3, 2021 Accepting new patients
Northern Montana Hospital CurrentSince Nov 29, 2017 Accepting new patients
CMSC, LLC CurrentSince Apr 16, 2018 Accepting new patients
Montana Gastroenterology, PLLC CurrentSince Sep 1, 2021 Accepting new patients
Madison Anesthesia Services PA Nurse Anesthetist, Certified Registered Past Accepting new patients
Montana Endoscopy Center, PLLC Past Accepting new patients
Visionary Surgery Center, LLC Past Accepting new patients

Locations

3010 15th Ave S
Great Falls, MT 59405
Phone (406) 771-3095

1509 29th St S
Great Falls, MT 59405
Phone (406) 771-3500

30 13th St
Havre, MT 59501
Phone (406) 262-1302

500 W Broadway St
Ste A
Missoula, MT 59802
Phone (406) 284-5560

1930 W Broadway St
Ste A
Missoula, MT 59808
Phone (406) 541-6844

Organizations & group practices 9

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1152144000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728259200000",
    "number": "1003847104",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1930 W BROADWAY ST STE A",
            "city": "MISSOULA",
            "state": "MT",
            "postal_code": "598081960",
            "telephone_number": "406-541-6844",
            "fax_number": "406-541-6843"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1930 W BROADWAY ST STE A",
            "city": "MISSOULA",
            "state": "MT",
            "postal_code": "598081960",
            "telephone_number": "406-541-6844",
            "fax_number": "406-541-6843"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "450 E Main St",
            "address_purpose": "LOCATION",
            "city": "Rexburg",
            "state": "ID",
            "postal_code": "834402048",
            "country_code": "US",
            "telephone_number": "208-356-3691",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SCRUGGS",
        "first_name": "THOMAS",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-06",
        "last_updated": "2024-10-07",
        "certification_date": "2024-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MT",
            "license": "101158",
            "primary": true
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "ID",
            "license": "N-30039",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "805979900",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Missoula, MT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.