NPIMap

Organization Active NPI

Blue Cloud Anesthesia, LLC

  • Anesthesiology Physician
  • Bridgeton, MO
National Provider Identifier
1790562379
Registry record updated Jan 27, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
Legal business name
BLUE CLOUD ANESTHESIA, LLC
Practice address
12184 Natural Bridge Rd # 90
Bridgeton, MO 63044-2017
Phone
(314) 391-4936
Fax
(314) 474-0191
NPI assigned
Sep 8, 2023
Last updated
Jan 27, 2025By the provider in NPPES
Organization subpart
Yes
Parent organization
BLUE CLOUD ANESTHESIA, LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jan 27, 2025

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

Authorized official

Name
Devin Larsen
Title
Ceo
Phone
(208) 340-1840

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X NU Primary

Addresses

Primary practice location

12184 Natural Bridge Rd # 90
Bridgeton, MO 63044-2017

Mailing address

9709 Lakeside Blvd Ste 350
Spring, TX 77381-1213
Phone (713) 489-2198

National Provider Directory

National Provider Directory
Tax ID family
Blue Cloud Anesthesia LLC6 organizations share this tax ID, including this one
Part of
Blue Cloud Anesthesia LLC

Other organizations with this tax ID 5

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1694131200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1737936000000",
    "number": "1790562379",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9709 LAKESIDE BLVD STE 350",
            "city": "SPRING",
            "state": "TX",
            "postal_code": "773811213",
            "telephone_number": "713-489-2198",
            "fax_number": "713-489-2978"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12184 NATURAL BRIDGE RD # 90",
            "city": "BRIDGETON",
            "state": "MO",
            "postal_code": "630442017",
            "telephone_number": "314-391-4936",
            "fax_number": "314-474-0191"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLUE CLOUD ANESTHESIA, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "BLUE CLOUD ANESTHESIA, LLC",
        "enumeration_date": "2023-09-08",
        "last_updated": "2025-01-27",
        "certification_date": "2025-01-27",
        "status": "A",
        "authorized_official_last_name": "LARSEN",
        "authorized_official_first_name": "DEVIN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "208-340-1840"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bridgeton, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2025; 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.