NPIMap

Organization Active NPI

Treasure Valley Anesthesia PC

  • Certified Registered Nurse Anesthetist
  • Ontario, OR
National Provider Identifier
1215992003
Registry record updated Jul 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
Legal business name
TREASURE VALLEY ANESTHESIA PC
Practice address
351 SW 9TH St
Ontario, OR 97914
Phone
(541) 881-7140
NPI assigned
Apr 18, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2024

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

Authorized official

Name
Cole R Shawver, CRNANPI 1912300120
Title
President
Phone
(208) 604-0348

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse AnesthetistGroup: 193400000X SINGLE SPECIALTY GROUP 367500000X Primary

Addresses

Primary practice location

351 SW 9TH St
Ontario, OR 97914

Mailing address

24442 Nubian Goat CT
Caldwell, ID 83607-8525
Phone (208) 604-0348

Other identifiers 3

IdentifierTypeStateIssuer
006401000OtherORREGENCE BCBSO
276579MedicaidOR
805134400MedicaidID

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040810000538 OR Part B Supplier - Clinic/Group Practice 2365414497 Receives reassigned benefits from 8 practitioners
Practice locations: Ontario, OR

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 8

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1145318400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1720396800000",
    "number": "1215992003",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24442 NUBIAN GOAT CT",
            "city": "CALDWELL",
            "state": "ID",
            "postal_code": "836078525",
            "telephone_number": "208-604-0348"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "351 SW 9TH ST",
            "city": "ONTARIO",
            "state": "OR",
            "postal_code": "97914",
            "telephone_number": "541-881-7140"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TREASURE VALLEY ANESTHESIA PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-18",
        "last_updated": "2024-07-08",
        "certification_date": "2024-07-08",
        "status": "A",
        "authorized_official_last_name": "SHAWVER",
        "authorized_official_first_name": "COLE",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "208-604-0348",
        "authorized_official_credential": "CRNA"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGENCE BCBSO",
            "identifier": "006401000",
            "state": "OR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "276579",
            "state": "OR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "805134400",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ontario, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.