Advanced Anesthesia, LLC

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

RNA613A Issued in NU

Legal business name

ADVANCED ANESTHESIA, LLC

Practice address

1155 Pocatello Creek Rd
Pocatello, ID 83201-2949

Phone

(208) 238-6337

NPI assigned

Apr 6, 2018

Last updated

Apr 6, 2018By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Dorian S. Grunig, CRNANPI 1982610549

Title

President

Phone

(208) 390-7757

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in ID

Enrollment records 1

Practitioners 1

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.

• Dorian S Grunig, CRNA

  • Certified Registered Nurse Anesthetist
  • Montpelier, ID
  • NPI 1982610549
  Medicare reassignment Authorized official

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

{
    "created_epoch": "1522972800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1522972800000",
    "number": "1407353428",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "115 CANYON RD",
            "city": "MONTPELIER",
            "state": "ID",
            "postal_code": "832541218",
            "telephone_number": "208-390-7757"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1155 POCATELLO CREEK RD",
            "city": "POCATELLO",
            "state": "ID",
            "postal_code": "832012949",
            "telephone_number": "208-238-6337"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVANCED ANESTHESIA, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-04-06",
        "last_updated": "2018-04-06",
        "status": "A",
        "authorized_official_last_name": "GRUNIG",
        "authorized_official_first_name": "DORIAN",
        "authorized_official_middle_name": "S.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "208-390-7757",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "CRNA"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "NU",
            "license": "RNA613A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Certified Registered Nurse Anesthetist in Pocatello, ID
• Providers in Pocatello, ID by specialty
• Certified Registered Nurse Anesthetist in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 6, 2018; 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.