NPIMap

Organization Active NPI

T-Medica Mobil Anesthesia Inc.

  • Certified Registered Nurse Anesthetist
  • Meridian, ID
National Provider Identifier
1306588355
Registry record updated Apr 11, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
Legal business name
T-MEDICA MOBIL ANESTHESIA INC.
Practice address
3520 E Louise Dr
Meridian, ID 83642-6304
Phone
(250) 888-8090
NPI assigned
Apr 11, 2022
Last updated
Apr 11, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 11, 2022

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

Authorized official

Name
Tammy Lee Skidmore, CRNANPI 1427008176
Title
Owner
Phone
(208) 339-5492

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 Anesthetist 367500000X Primary

Addresses

Primary practice location

3520 E Louise Dr
Meridian, ID 83642-6304

Mailing address

PO Box 2681
Idaho Falls, ID 83403-2681
Phone (208) 525-2090

Other practice location 1

333 N 1st St Ste 240
Boise, ID 83702-6132
Phone (208) 338-8900

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20220614001826 ID Part B Supplier - Clinic/Group Practice 9931588498 Receives reassigned benefits from 1 practitioner
Practice locations: Meridian, ID

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 48

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 48

NPI Registry JSON

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

{
    "created_epoch": "1649635200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1649635200000",
    "number": "1306588355",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2681",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834032681",
            "telephone_number": "208-525-2090",
            "fax_number": "208-523-8978"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3520 E LOUISE DR",
            "city": "MERIDIAN",
            "state": "ID",
            "postal_code": "836426304",
            "telephone_number": "250-888-8090"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "333 N 1st St Ste 240",
            "address_purpose": "LOCATION",
            "city": "Boise",
            "state": "ID",
            "postal_code": "837026132",
            "country_code": "US",
            "telephone_number": "208-338-8900",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "T-MEDICA MOBIL ANESTHESIA INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-04-11",
        "last_updated": "2022-04-11",
        "certification_date": "2022-04-11",
        "status": "A",
        "authorized_official_last_name": "SKIDMORE",
        "authorized_official_first_name": "TAMMY",
        "authorized_official_middle_name": "LEE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "208-339-5492",
        "authorized_official_credential": "CRNA"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_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 Apr 11, 2022; 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.