Active NPI
Elite Anesthesia Services of Idaho
- Certified Registered Nurse Anesthetist
- Meridian, ID
National Provider Identifier
1407437155
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Certified Registered Nurse Anesthetist
- Legal business name
- ELITE ANESTHESIA SERVICES OF IDAHO
- Practice address
- 2960 E St. Luke'S Street
Meridian, ID 83642 - Phone
- (208) 378-4264
- NPI assigned
- Apr 15, 2021
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Joshua Coleman, CRNA
- Title
- Owner/Managing Partner
- Phone
- (909) 773-2901
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Certified Registered Nurse Anesthetist | 367500000X | Primary |
Addresses
Primary practice location
2960 E St. Luke'S Street
Meridian, ID 83642
Mailing address
5976 W Venetian Dr
Eagle, ID 83616-7439
National Provider Directory
National Provider DirectoryPractitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Certified Registered Nurse Anesthetist
- Boise, ID
- NPI 1760897409
Nurse Anesthetist, Certified Registered
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1618444800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1618444800000",
"number": "1407437155",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5976 W VENETIAN DR",
"city": "EAGLE",
"state": "ID",
"postal_code": "836167439"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2960 E ST. LUKE'S STREET",
"city": "MERIDIAN",
"state": "ID",
"postal_code": "83642",
"telephone_number": "208-378-4264"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "ELITE ANESTHESIA SERVICES OF IDAHO",
"organizational_subpart": "NO",
"enumeration_date": "2021-04-15",
"last_updated": "2021-04-15",
"certification_date": "2021-03-23",
"status": "A",
"authorized_official_last_name": "COLEMAN",
"authorized_official_first_name": "JOSHUA",
"authorized_official_title_or_position": "OWNER/MANAGING PARTNER",
"authorized_official_telephone_number": "909-773-2901",
"authorized_official_credential": "CRNA"
},
"taxonomies": [
{
"code": "367500000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY 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 15, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.