Active NPI
Michelene Morin, CRNA
- Certified Registered Nurse Anesthetist
- Coeur D Alene, ID
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Certified Registered Nurse Anesthetist
- License
- 75764
- Practice address
- 2003 Kootenai Health Way
Coeur D Alene, ID 83814-6051 - Phone
- (208) 625-6400
- NPI assigned
- Mar 14, 2022
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 0001242619 | VA | |
| Certified Registered Nurse Anesthetist | 367500000X | 75764 | ID | Primary |
Addresses
Primary practice location
2003 Kootenai Health Way
Coeur D Alene, ID 83814-6051
Mailing address
PO Box 35145 #40023
Seattle, WA 98124-5145
Other practice location 1
921 Grove Ln
Roanoke, VA 24012-1003
Phone (276) 620-0683
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in ID
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20230412001719 | ID | Practitioner - Certified Registered Nurse Anesthetist (Crna) | 4284009820 | Reassigns benefits to 1 organization |
Care Compare profile
Medicare Care Compare- Specialty
- Certified Registered Nurse Anesthetist (Crna)
- Education
- Virginia Commonwealth University, School of Medicine, 2022
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Anesthesia Associates of Coeur D Alene PLLC
Practice addresses (Care Compare)
2003 Kootenai Health Way
Coeur D Alene, ID 83814-6051
Phone (208) 625-6400
Hospital & facility affiliations
- Kootenai Health
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0001242619 | VA | MD | Registered Nurse |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Anesthesia Associates of Coeur D Alene PLLC | Single Specialty | Current | Accepting new patients |
Locations
2003 Kootenai Health Way
Coeur D Alene, ID 83814
Phone (208) 625-5085
1919 Lincoln Way
Ste 415
Coeur D Alene, ID 83814
Phone (208) 625-4595
Organizations & group practices 1
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.
-
- Anesthesiology Physician
- Coeur D Alene, ID
- NPI 1962440966
ID, Single Specialty
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1647216000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1681776000000",
"number": "1194473769",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 35145 #40023",
"city": "SEATTLE",
"state": "WA",
"postal_code": "981245145"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2003 KOOTENAI HEALTH WAY",
"city": "COEUR D ALENE",
"state": "ID",
"postal_code": "838146051",
"telephone_number": "208-625-6400"
}
],
"practiceLocations": [
{
"address_1": "921 Grove Ln",
"address_purpose": "LOCATION",
"city": "Roanoke",
"state": "VA",
"postal_code": "240121003",
"country_code": "US",
"telephone_number": "276-620-0683",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "MORIN",
"first_name": "MICHELENE",
"credential": "CRNA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2022-03-14",
"last_updated": "2023-04-18",
"certification_date": "2023-04-12",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Registered Nurse",
"state": "VA",
"license": "0001242619",
"primary": false
},
{
"code": "367500000X",
"taxonomy_group": "",
"desc": "Nurse Anesthetist, Certified Registered",
"state": "ID",
"license": "75764",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Coeur D Alene, ID
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 2023; 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.