Organization Active NPI

Wimmis Sleep PLLC

  • Certified Registered Nurse Anesthetist
  • Meridian, ID
National Provider Identifier
1235944083
Registry record updated Feb 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
Legal business name
WIMMIS SLEEP PLLC
Practice address
2264 E Cinema Dr
Meridian, ID 83642-8249
Phone
(208) 381-0262
Fax
(208) 429-8575
NPI assigned
Feb 10, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 10, 2025

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

Authorized official

Name
Spencer Stucki, CRNANPI 1518100759
Title
Owner
Phone
(801) 510-1443

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

2264 E Cinema Dr
Meridian, ID 83642-8249

Mailing address

PO Box 2513
Idaho Falls, ID 83403-2513
Phone (800) 338-5378

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250801003178 ID Part B Supplier - Clinic/Group Practice 1951819838 Practice locations: Meridian, ID

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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": "1739145600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1739145600000",
    "number": "1235944083",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2513",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834032513",
            "telephone_number": "800-338-5378",
            "fax_number": "208-523-8978"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2264 E CINEMA DR",
            "city": "MERIDIAN",
            "state": "ID",
            "postal_code": "836428249",
            "telephone_number": "208-381-0262",
            "fax_number": "208-429-8575"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WIMMIS SLEEP PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-02-10",
        "last_updated": "2025-02-10",
        "certification_date": "2025-02-10",
        "status": "A",
        "authorized_official_last_name": "STUCKI",
        "authorized_official_first_name": "SPENCER",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "801-510-1443",
        "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": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Meridian, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 2025; 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.