NPIMap

Organization Active NPI

West Idaho Anesthesia, LLP

  • Certified Registered Nurse Anesthetist
  • Caldwell, ID
National Provider Identifier
1871918318
Registry record updated Feb 20, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
Legal business name
WEST IDAHO ANESTHESIA, LLP
Practice address
3115 Medical Dr
Caldwell, ID 83605-6972
Phone
(208) 453-8668
Fax
(208) 523-2025
NPI assigned
Feb 20, 2014
Last updated
Feb 20, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 20, 2014

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

Authorized official

Name
Mr. Shad B. Westover, CRNANPI 1407031180
Title
Partner
Phone
(208) 550-1042

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 1

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

Addresses

Primary practice location

3115 Medical Dr
Caldwell, ID 83605-6972

Mailing address

PO Box 3816
Idaho Falls, ID 83403-3816
Phone (208) 552-8572

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ID, OR2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20140616001943 ID Part B Supplier - Clinic/Group Practice 9133343031 Receives reassigned benefits from 31 practitioners
Practice locations: Meridian, ID; Caldwell, ID; Boise, ID
O20230310001114 OR Part B Supplier - Clinic/Group Practice 9133343031 Receives reassigned benefits from 8 practitioners
Practice locations: Ontario, OR

National Provider Directory

National Provider Directory

Member organizations 1

Organizations listed as members of this organization in the National Provider Directory.

Locations

2855 E Magic View Dr
Ste A
Meridian, ID 83642
Phone (208) 639-4920

Practitioners & affiliated clinicians

Practitioners 31

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 31

NPI Registry JSON

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

{
    "created_epoch": "1392854400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1392854400000",
    "number": "1871918318",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3816",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834033816",
            "telephone_number": "208-552-8572",
            "fax_number": "208-523-2025"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3115 MEDICAL DR",
            "city": "CALDWELL",
            "state": "ID",
            "postal_code": "836056972",
            "telephone_number": "208-453-8668",
            "fax_number": "208-523-2025"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WEST IDAHO ANESTHESIA, LLP",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-02-20",
        "last_updated": "2014-02-20",
        "status": "A",
        "authorized_official_last_name": "WESTOVER",
        "authorized_official_first_name": "SHAD",
        "authorized_official_middle_name": "B.",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "208-550-1042",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "CRNA"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Caldwell, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2014; 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.