Individual provider Active NPI

Jeffrey T Grover, CRNA

  • Certified Registered Nurse Anesthetist
  • Rexburg, ID
National Provider Identifier
1396859591
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
16378 Issued in ID
Practice address
450 E Main St
Rexburg, ID 83440-2048
Phone
(208) 356-3691
NPI assigned
Aug 18, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 16378 ID Primary

Addresses

Primary practice location

450 E Main St
Rexburg, ID 83440-2048

Mailing address

PO Box 3882
Idaho Falls, ID 83403-3882
Phone (208) 525-2090

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070104000447 ID Practitioner - Certified Registered Nurse Anesthetist (Crna) 6305850124 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Madison Anesthesia Services PAGroup PAC ID 9739174152, 10 clinicians

Practice addresses (Care Compare)

450 E Main St
Reburg, ID 83440-2048
Phone (208) 356-3691

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
16378IDMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Madison Anesthesia Services PA Anesthesiology CurrentSince Aug 1, 2006 Accepting new patients

Locations

2290 Coronado St
Idaho Falls, ID 83404
Phone (208) 522-4000

37 S 2nd E
Rexburg, ID 83440
Phone (208) 356-0234

381 E 4th N
Rexburg, ID 83440
Phone (208) 359-2300

450 E Main St
Rexburg, ID 83440
Phone (208) 356-3691

Organizations & group practices 1

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.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1155859200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1396859591",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3882",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834033882",
            "telephone_number": "208-525-2090",
            "fax_number": "208-525-2662"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "450 E MAIN ST",
            "city": "REXBURG",
            "state": "ID",
            "postal_code": "834402048",
            "telephone_number": "208-356-3691"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GROVER",
        "first_name": "JEFFREY",
        "middle_name": "T",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-18",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "ID",
            "license": "16378",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rexburg, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.

Verify at the official NPI Registry.