Michael Pekala, CRNA

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

N-24355 Issued in ID

Practice address

3100 Channing Way
Idaho Falls, ID 83404-7533

Phone

(208) 529-6111

NPI assigned

Jan 31, 2007

Last updated

Jun 24, 2010By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Registered Nurse

State licenses

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

{
    "created_epoch": "1170201600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1277337600000",
    "number": "1770620437",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "255 W MICHIGAN AVE",
            "address_2": "PO BOX 1123",
            "city": "JACKSON",
            "state": "MI",
            "postal_code": "492012218",
            "telephone_number": "866-570-0077",
            "fax_number": "248-479-0652"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3100 CHANNING WAY",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834047533",
            "telephone_number": "208-529-6111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEKALA",
        "first_name": "MICHAEL",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-31",
        "last_updated": "2010-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "ID",
            "license": "N-24355",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• William Edwin Pearson, DDS
• Dottie Peck, REEGT, CNIM
• Pediatric Development Clinic (PDC)
• Benjamin Richard Pedroza Jr., CPSS/CPRC/CPRC-SUP
• Carey Peeples
• Daniel Eric Pendlebury, AU.D.
• Kristy Ann Pendleton, LCSW
• Shaylene Peninger, LCSW
• Cali Nicole Perez-Verdia, FNP-BC
• Perfection Home Health

• Certified Registered Nurse Anesthetist in Idaho Falls, ID
• Providers in Idaho Falls, ID by specialty
• Certified Registered Nurse Anesthetist in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.