Individual provider Active NPI

Beau S. Daniel, CRNA

  • Certified Registered Nurse Anesthetist
  • Pocatello, ID
National Provider Identifier
1760712327
Registry record updated Oct 15, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
232645 Issued in AR
Practice address
285 Vista Dr
Pocatello, ID 83201-4987
Phone
(208) 478-1704
Fax
(770) 701-6673
NPI assigned
Jan 5, 2010
Last updated
Oct 15, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 15, 2025

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 232645 AR Primary
Certified Registered Nurse Anesthetist 367500000X RNA-936A ID

Addresses

Primary practice location

285 Vista Dr
Pocatello, ID 83201-4987

Mailing address

PO Box 3750
Salt Lake City, UT 84110-3750
Phone (800) 880-3566

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ID, KS, AR3 enrollments

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
I20160407001324 ID Practitioner - Certified Registered Nurse Anesthetist (Crna) 4082758446 Reassigns benefits to 3 organizations
I20250925003128 KS Practitioner - Certified Registered Nurse Anesthetist (Crna) 4082758446 Reassigns benefits to 1 organization
I20251009003887 AR Practitioner - Certified Registered Nurse Anesthetist (Crna) 4082758446 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Premier Anesthesia of Arkansas Professional CorporationGroup PAC ID 6406077460, 87 clinicians
Premier Anesthesia of Washington, PCGroup PAC ID 1153823083, 37 clinicians

Practice addresses (Care Compare)

3215 N N Hills Blvd
Fayetteville, AR 72703-4424
Phone (479) 463-1000

400 S Santa Fe Ave
Salina, KS 67401-4144
Phone (678) 690-7816

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RNA-936AIDMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Valley View Anesthesia PA CurrentSince Mar 28, 2019 Accepting new patients
Premier Anesthesia of Washington, PC Nurse Anesthetist, Certified Registered CurrentSince Aug 1, 2025 Accepting new patients
Mountain View Hospital LLC CurrentSince Apr 1, 2016 Accepting new patients
Premier Anesthesia of Arkansas Professional Corporation Nurse Anesthetist, Certified Registered CurrentSince Sep 1, 2025 Accepting new patients
Madison Avenue Surgery Center LLC Past Accepting new patients

Locations

3215 N Northhills Blvd
Fayetteville, AR 72703
Phone (479) 463-1025

2655 Northwinds Pkwy
Alpharetta, GA 30009
Phone (678) 690-7804

2325 Coronado St
Idaho Falls, ID 83404
Phone (208) 528-7686

285 Vista Dr
Pocatello, ID 83201
Phone (208) 233-8344

400 S Santa Fe Ave
Salina, KS 67401
Phone (785) 452-6019

Organizations & group practices 6

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": "1262649600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1760486400000",
    "number": "1760712327",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3750",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841103750",
            "telephone_number": "800-880-3566",
            "fax_number": "770-701-6676"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "285 VISTA DR",
            "city": "POCATELLO",
            "state": "ID",
            "postal_code": "832014987",
            "telephone_number": "208-478-1704",
            "fax_number": "770-701-6673"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DANIEL",
        "first_name": "BEAU",
        "middle_name": "S.",
        "name_prefix": "Mr.",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-01-05",
        "last_updated": "2025-10-15",
        "certification_date": "2025-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "AR",
            "license": "232645",
            "primary": true
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "ID",
            "license": "RNA-936A",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pocatello, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2025; 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.