Organization Active NPI

Alpine Anesthesia LLC

  • Certified Registered Nurse Anesthetist
  • Idaho Falls, ID
National Provider Identifier
1679302137
Registry record updated Jul 31, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
Legal business name
ALPINE ANESTHESIA LLC
Practice address
3345 S Holmes Ave
Idaho Falls, ID 83404-7981
Phone
(208) 528-2858
NPI assigned
Jul 31, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 31, 2024

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

Authorized official

Name
Brenda Hatch, CRNANPI 1740362797
Title
Owner
Phone
(208) 680-8478

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse AnesthetistGroup: 193400000X SINGLE SPECIALTY GROUP 367500000X Primary

Addresses

Primary practice location

3345 S Holmes Ave
Idaho Falls, ID 83404-7981

Mailing address

PO Box 1385
Idaho Falls, ID 83403-1385
Phone (208) 525-2090

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240916000716 ID Part B Supplier - Clinic/Group Practice 1153862362 Receives reassigned benefits from 1 practitioner
Practice locations: Idaho Falls, ID

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1722384000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1722384000000",
    "number": "1679302137",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1385",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834031385",
            "telephone_number": "208-525-2090",
            "fax_number": "208-523-8978"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3345 S HOLMES AVE",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834047981",
            "telephone_number": "208-528-2858"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ALPINE ANESTHESIA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-07-31",
        "last_updated": "2024-07-31",
        "certification_date": "2024-07-31",
        "status": "A",
        "authorized_official_last_name": "HATCH",
        "authorized_official_first_name": "BRENDA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "208-680-8478",
        "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 Idaho Falls, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2024; 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.