Individual provider Active NPI

Gregory S Thomas, CRNA

  • Certified Registered Nurse Anesthetist
  • Boise, ID
National Provider Identifier
1679607303
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
RNA684 Issued in ID
Practice address
111 W State St
Boise, ID 83702-6127
Phone
(208) 336-0895
Fax
(208) 338-1796
NPI assigned
Mar 15, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X RNA684 ID Primary

Addresses

Primary practice location

111 W State St
Boise, ID 83702-6127

Mailing address

111 W State St
Boise, ID 83702-6127
Phone (208) 336-0895

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160929002295 UT Practitioner - Certified Registered Nurse Anesthetist (Crna) 4688772650 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

65 N Gateway Dr
Suite 3
Providence, UT 84332-6102
Phone (435) 535-3257

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RNA684IDMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Wasatch Anesthesia LLC Nurse Anesthetist, Certified Registered CurrentSince Jan 7, 2025 Accepting new patients
Mt Ogden Anesthesia Group LLC Nurse Anesthetist, Certified Registered CurrentSince Oct 1, 2016 Accepting new patients
Anesthesia Associates of Boise, P.a. PastSince Jun 17, 1997 Accepting new patients

Locations

65 N Gateway Dr
Ste 3
Providence, UT 84332
Phone (435) 213-6563

560 W 465 N
Ste 604
Providence, UT 84332
Phone (435) 753-1600

4364 Washington Blvd
South Ogden, UT 84403
Phone (801) 224-6767

161 W 200 N
Ste 105
St George, UT 84770
Phone (435) 216-7063

Interoperability endpoints

  • Direct secure messaging: gregory.thomas.1@17373.direct.athenahealth.com

Organizations & group practices 3

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": "1173916800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1679607303",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 W STATE ST",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837026127",
            "telephone_number": "208-336-0895",
            "fax_number": "208-338-1796"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 W STATE ST",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837026127",
            "telephone_number": "208-336-0895",
            "fax_number": "208-338-1796"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOMAS",
        "first_name": "GREGORY",
        "middle_name": "S",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-15",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "ID",
            "license": "RNA684",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boise, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.