Moose Creek Anesthesia PC

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

Legal business name

MOOSE CREEK ANESTHESIA PC

Practice address

3925 Washington Pkwy
Idaho Falls, ID 83404-7596

Phone

(208) 201-4973

NPI assigned

Jul 15, 2025

Organization subpart

No

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

Authorized official

Name

Teresa Tegan

Title

Credentialing & Billing

Phone

(208) 734-7362

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in ID

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Travis M Pickett, CRNA

  • Certified Registered Nurse Anesthetist
  • Idaho Falls, ID
  • NPI 1376622894

  Nurse Anesthetist, Certified Registered

  Medicare reassignment NPD

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

{
    "created_epoch": "1752537600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1762387200000",
    "number": "1922990035",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5341 TILDY LN",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834016038",
            "telephone_number": "208-734-7362",
            "fax_number": "208-733-9463"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3925 WASHINGTON PKWY",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834047596",
            "telephone_number": "208-201-4973"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "23 Sawtelle Ave",
            "address_purpose": "LOCATION",
            "city": "Rexburg",
            "state": "ID",
            "postal_code": "834401499",
            "country_code": "US",
            "telephone_number": "208-734-7362",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "MOOSE CREEK ANESTHESIA PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-07-15",
        "last_updated": "2025-11-06",
        "certification_date": "2025-11-06",
        "status": "A",
        "authorized_official_last_name": "TEGAN",
        "authorized_official_first_name": "TERESA",
        "authorized_official_title_or_position": "CREDENTIALING & BILLING",
        "authorized_official_telephone_number": "208-734-7362"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Heather A Moore, RN
• Jared Lee Moore, PHARMD
• Kailey Lynn Moore
• Megan Marie Moore, CCC-SLP
• Michael Kirk Moore Jr., M.D., P.C.
• Mooso Orthodontics
• Brett Eddis Mooso, D.D.S.,M.S.,P.A.
• Karla Jerica Mora-Cardona, BS
• Marian F. Morgan, LCSW EDS
• Ricky Morgan, DPT, ATC

• 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 Nov 6, 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.