Active NPI
Rand N. Bracken, CRNA
- Certified Registered Nurse Anesthetist
- Burley, ID
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Certified Registered Nurse Anesthetist
- License
- RNA-959A
- Practice address
- 1501 Hiland Ave
Burley, ID 83318-2688 - Phone
- (208) 678-4444
- NPI assigned
- Feb 3, 2006
- Last updated
- Aug 11, 2026
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Certified Registered Nurse Anesthetist | 367500000X | CRNA000310 | NV | |
| Certified Registered Nurse Anesthetist | 367500000X | RNA-959A | ID | Primary |
| Anesthesiology Physician | 207L00000X | RNA-959A | ID |
Addresses
Primary practice location
1501 Hiland Ave
Burley, ID 83318-2688
Mailing address
PO Box 30180
Salt Lake City, UT 84130-0180
Phone (208) 678-4444
Other practice location 1
700 S Main St
Moscow, ID 83843-3056
Phone (208) 882-4511
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | https://esmd.officeally.io.8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service | Other | Bluemark LLC / Office Ally |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in ID
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Certified Registered Nurse Anesthetist (Crna)
- Education
- Other, 2005
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
1501 Hiland Ave
Burley, ID 83318-2688
Phone (208) 678-4444
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Certified Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RNA-959A | ID | MD | Anesthesiology Physician |
| CRNA000310 | NV | MD | Certified Registered Nurse Anesthetist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Sheridan Healthcare of Colorado PC | Anesthesiology | Past | Accepting new patients |
| Banner Anesthesiologists West, LLC | Past | Accepting new patients |
Organizations & group practices 3
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Certified Registered Nurse Anesthetist
- Burley, ID
- NPI 1659838027
-
- Multi-Specialty Clinic/Center
- Fallon, NV
- NPI 1780044222
-
- Certified Registered Nurse Anesthetist
- Pueblo, CO
- NPI 1437132990
Anesthesiology
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
dba Intermountain Health Cassia Regional Hospital
- General Acute Care Hospital
- Burley, ID
- NPI 1497865315
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1138924800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1786406400000",
"number": "1386616332",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 30180",
"city": "SALT LAKE CITY",
"state": "UT",
"postal_code": "841300180",
"telephone_number": "208-678-4444"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1501 HILAND AVE",
"city": "BURLEY",
"state": "ID",
"postal_code": "833182688",
"telephone_number": "208-678-4444"
}
],
"practiceLocations": [
{
"address_1": "700 S Main St",
"address_purpose": "LOCATION",
"city": "Moscow",
"state": "ID",
"postal_code": "838433056",
"country_code": "US",
"telephone_number": "208-882-4511",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "BRACKEN",
"first_name": "RAND",
"middle_name": "N.",
"credential": "CRNA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-02-03",
"last_updated": "2026-08-11",
"certification_date": "2026-08-11",
"status": "A"
},
"taxonomies": [
{
"code": "367500000X",
"taxonomy_group": "",
"desc": "Nurse Anesthetist, Certified Registered",
"state": "NV",
"license": "CRNA000310",
"primary": false
},
{
"code": "367500000X",
"taxonomy_group": "",
"desc": "Nurse Anesthetist, Certified Registered",
"state": "ID",
"license": "RNA-959A",
"primary": true
},
{
"code": "207L00000X",
"taxonomy_group": "",
"desc": "Anesthesiology",
"state": "ID",
"license": "RNA-959A",
"primary": false
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "CONNECT",
"endpointTypeDescription": "CONNECT URL",
"endpoint": "https://esmd.officeally.io.8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service",
"affiliation": "Y",
"endpointDescription": "2.16.840.1.113883.3.2019.3",
"affiliationName": "Bluemark LLC / Office Ally",
"use": "OTHER",
"useDescription": "Other",
"useOtherDescription": "CMS esMD eMDR",
"address_1": "1300 SE Cardinal Ct Ste 190",
"city": "Vancouver",
"state": "WA",
"country_code": "US",
"postal_code": "986839683",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Burley, ID
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 2026; 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.