Individual provider Active NPI

Zackery Davison, CRNA

  • Certified Registered Nurse Anesthetist
  • Great Falls, MT
National Provider Identifier
1619738333
Registry record updated Jun 27, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
238996 Issued in MT
Practice address
1101 26TH St S
Great Falls, MT 59405-5161
Phone
(406) 731-8888
Fax
(406) 731-8318
NPI assigned
Jan 19, 2024
Last updated
Jun 27, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 27, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 35507 TN
Certified Registered Nurse Anesthetist 367500000X 238996 MT Primary

Addresses

Primary practice location

1101 26TH St S
Great Falls, MT 59405-5161

Mailing address

PO Box 6010
Great Falls, MT 59406-6010

Other practice location 1

1 Medical Center Blvd
Cookeville, TN 38501-4294
Phone (931) 528-2541

Other practice location 2

1645 Vandelay Ave Ste 201
Helena, MT 59601-3929
Phone (406) 731-8888

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN, MT2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20240717004082 TN Practitioner - Certified Registered Nurse Anesthetist (Crna) 5698210375 Reassigns benefits to 1 organization
I20240730002326 MT Practitioner - Certified Registered Nurse Anesthetist (Crna) 5698210375 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
CMSC LLCGroup PAC ID 5890602494, 92 clinicians

Practice addresses (Care Compare)

1509 29TH St S
Great Falls, MT 59405-5363
Phone (406) 771-3500

3000 15TH Ave S
Great Falls, MT 59405-5240
Phone (406) 454-2171

3010 15TH Ave S
Great Falls, MT 59405-5240
Phone (406) 216-8000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
CMSC, LLC CurrentSince Nov 1, 2025 Accepting new patients
Benefis Hospitals Inc CurrentSince Jul 17, 2024 Accepting new patients
Lifelinc Anesthesia II, PLLC Anesthesiology CurrentSince Jun 21, 2024 Accepting new patients
Benefis Hospitals, Inc. CurrentSince Jul 17, 2024 Accepting new patients

Locations

1101 26th St S
Great Falls, MT 59405
Phone (406) 455-4690

1101 26th St S
Fl 5
Great Falls, MT 59405
Phone (406) 455-2132

1401 25th St S
Great Falls, MT 59405
Phone (406) 455-3650

1509 29th St S
Great Falls, MT 59405
Phone (406) 771-3500

3010 15th Ave S
Great Falls, MT 59405
Phone (406) 771-3095

1645 Vandelay Ave
Ste 201
Helena, MT 59601
Phone (406) 389-2505

1 Medical Center Blvd
Cookeville, TN 38501
Phone (931) 783-2334

3340 Players Club Pkwy
Ste 350
Memphis, TN 38125
Phone (901) 207-2017

100 Northcrest Dr
Springfield, TN 37172
Phone (615) 384-1531

Organizations & group practices 4

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 1

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": "1705622400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719446400000",
    "number": "1619738333",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 6010",
            "city": "GREAT FALLS",
            "state": "MT",
            "postal_code": "594066010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1101 26TH ST S",
            "city": "GREAT FALLS",
            "state": "MT",
            "postal_code": "594055161",
            "telephone_number": "406-731-8888",
            "fax_number": "406-731-8318"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1 Medical Center Blvd",
            "address_purpose": "LOCATION",
            "city": "Cookeville",
            "state": "TN",
            "postal_code": "385014294",
            "country_code": "US",
            "telephone_number": "931-528-2541",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1645 Vandelay Ave Ste 201",
            "address_purpose": "LOCATION",
            "city": "Helena",
            "state": "MT",
            "postal_code": "596013929",
            "country_code": "US",
            "telephone_number": "406-731-8888",
            "fax_number": "406-731-8318",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DAVISON",
        "first_name": "ZACKERY",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-01-19",
        "last_updated": "2024-06-27",
        "certification_date": "2024-06-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "TN",
            "license": "35507",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MT",
            "license": "238996",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Great Falls, MT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 2024; 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.