Cory J Nelson
Individual provider Active NPI Certified Registered Nurse Anesthetist · Plains, MT
NPI 1295843886 · NPPES record last updated Feb 20, 2008
Key facts
- NPI
- 1295843886
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Certified Registered Nurse Anesthetist 367500000X
- License
- 35436 (MT)
- Practice address
- 10 Kruger Rd
Plains, MT 59859-9506 - Phone
- (406) 826-4800
- Fax
- (406) 826-4816
- NPI assigned
- Aug 25, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Hospital & facility affiliations 1
Medicare Care Compare profile
- Specialty
- Certified Registered Nurse Anesthetist (Crna)
- Education
- Other, 2005
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Anesthesia Associates of Boise, P.a.
Practice addresses (Care Compare)
1000 State St
McCall, ID 83638-3704
Phone (208) 634-2221
Hospital & facility affiliations
- St Luke'S McCall
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in ID
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20060406000036 | ID | Practitioner - Certified Registered Nurse Anesthetist (Crna) | 5799794509 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Certified Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 35436 | MT | MD | Certified Registered Nurse Anesthetist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Anesthesia Associates of Boise, P.a. | Current |
Accepting new patients |
Locations
2537 W State St
Ste 200
Boise, ID 83702
Phone (208) 336-0895
338 E Bannock St
Boise, ID 83712
Phone (208) 336-0895
1000 State St
McCall, ID 83638
Phone (208) 634-2221
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Certified Registered Nurse Anesthetist | 367500000X | 35436 | MT | Yes |
Addresses
Primary practice location
10 Kruger Rd
Plains, MT 59859-9506
Mailing address
PO Box 768
Plains, MT 59859-0768
Phone (406) 826-4800
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 412509 | Medicaid | MT |
Other providers in Plains, MT
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- Stuart Meints
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- New Horizons Counseling, L.L.C.
- Gwenna Carie Olson
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All providers in Plains, MT · Certified Registered Nurse Anesthetist in Montana
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 20, 2008. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.