NPIMap

Organization Active NPI

Innovative Anesthesia Solutions PLLC

  • Certified Registered Nurse Anesthetist
  • St George, UT
National Provider Identifier
1730766098
Registry record updated Apr 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
Legal business name
INNOVATIVE ANESTHESIA SOLUTIONS PLLC
Practice address
585 E Riverside Dr
St George, UT 84790-7141
Phone
(435) 673-8080
Fax
(435) 673-0096
NPI assigned
Mar 24, 2021
Last updated
Apr 21, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 21, 2025

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

Authorized official

Name
Mr. Jerry Hadlock, CRNANPI 1487904298
Title
Managing Partner
Phone
(435) 673-8080

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X
Certified Registered Nurse Anesthetist 367500000X Primary

Addresses

Primary practice location

585 E Riverside Dr
St George, UT 84790-7141

Mailing address

PO Box 1169
Bountiful, UT 84011-1169
Phone (435) 673-8080

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210818002306 UT Part B Supplier - Clinic/Group Practice 2062817760 Receives reassigned benefits from 12 practitioners
Practice locations: St George, UT

National Provider Directory

National Provider Directory

Locations

585 E Riverside Dr
Ste 100
St George, UT 84790
Phone (435) 310-5414

676 S Bluff St
#101
St George, UT 84770
Phone (435) 673-8080

Practitioners & affiliated clinicians

Practitioners 15

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1616544000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1745193600000",
    "number": "1730766098",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1169",
            "city": "BOUNTIFUL",
            "state": "UT",
            "postal_code": "840111169",
            "telephone_number": "435-673-8080",
            "fax_number": "801-951-2351"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "585 E RIVERSIDE DR",
            "city": "ST GEORGE",
            "state": "UT",
            "postal_code": "847907141",
            "telephone_number": "435-673-8080",
            "fax_number": "435-673-0096"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INNOVATIVE ANESTHESIA SOLUTIONS PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-03-24",
        "last_updated": "2025-04-21",
        "certification_date": "2025-04-21",
        "status": "A",
        "authorized_official_last_name": "HADLOCK",
        "authorized_official_first_name": "JERRY",
        "authorized_official_title_or_position": "MANAGING PARTNER",
        "authorized_official_telephone_number": "435-673-8080",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "CRNA"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in St George, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 2025; 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.