Individual provider Active NPI

Aimee M Racette, CRNA

  • Certified Registered Nurse Anesthetist
  • Jackson, WY
National Provider Identifier
1679598767
Registry record updated Feb 18, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
1729 Issued in WY
Practice address
625 E Broadway Ave
Jackson, WY 83001-8642
Phone
(073) 739-7218
NPI assigned
Jul 12, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 18, 2021

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 120548 CO
Certified Registered Nurse Anesthetist 367500000X RN-120548 CO
Certified Registered Nurse Anesthetist 367500000X CRA-4217 CO
Certified Registered Nurse Anesthetist 367500000X 1729 WY Primary

Addresses

Primary practice location

625 E Broadway Ave
Jackson, WY 83001-8642

Mailing address

PO Box 428
Jackson, WY 83001-0428
Phone (307) 739-7218

Other practice location 1

501 E Hampden Avenue
Englewood, CO 80113-2702
Phone (303) 788-6749

Other identifiers 2

IdentifierTypeStateIssuer
149185700MedicaidWY
29254272MedicaidCO

Other names 1

  • Ms. Aimee M Moffitt Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address aracette@sjmc.cernerdirect.com Direct

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180411002949 WY Practitioner - Certified Registered Nurse Anesthetist (Crna) 6608762711 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Grand Teton Anesthesia LLCGroup PAC ID 2961796826, 7 clinicians

Practice addresses (Care Compare)

150 Buffalo Way
Jackson, WY 83002
Phone (307) 733-8677

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
213974TXMDOccupational Therapy Assistant
120548COMDCertified Registered Nurse Anesthetist
CRA-4217COMDCertified Registered Nurse Anesthetist
RN-120548COMDCertified Registered Nurse Anesthetist
1729WYMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Grand Teton Anesthesia, LLC CurrentSince Apr 1, 2018 Accepting new patients
OB GYN Anesthesia PC Past Accepting new patients
Anesthesia Consultants PC Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: aracette@sjmc.cernerdirect.com

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1152662400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1613606400000",
    "number": "1679598767",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 428",
            "city": "JACKSON",
            "state": "WY",
            "postal_code": "830010428",
            "telephone_number": "307-739-7218",
            "fax_number": "307-739-7446"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "625 E BROADWAY AVE",
            "city": "JACKSON",
            "state": "WY",
            "postal_code": "830018642",
            "telephone_number": "073-739-7218"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "501 E Hampden Avenue",
            "address_purpose": "LOCATION",
            "city": "Englewood",
            "state": "CO",
            "postal_code": "801132702",
            "country_code": "US",
            "telephone_number": "303-788-6749",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RACETTE",
        "first_name": "AIMEE",
        "middle_name": "M",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-12",
        "last_updated": "2021-02-18",
        "certification_date": "2021-02-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "CO",
            "license": "120548",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "CO",
            "license": "RN-120548",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "CO",
            "license": "CRA-4217",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "WY",
            "license": "1729",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "149185700",
            "state": "WY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "29254272",
            "state": "CO"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "aracette@sjmc.cernerdirect.com",
            "affiliation": "N",
            "endpointDescription": "Direct Messaging Address for St John's Health",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Other",
            "address_1": "625 E Broadway Ave",
            "city": "Jackson",
            "state": "WY",
            "country_code": "US",
            "postal_code": "830018642",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "AIMEE",
            "last_name": "MOFFITT",
            "middle_name": "M",
            "prefix": "MS.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Jackson, WY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 18, 2021; 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.