3 Peaks Anesthesia, Inc

Organization Active NPI Certified Registered Nurse Anesthetist · Idaho Falls, ID

NPI 1962030627 · NPPES record last updated Apr 28, 2020

Key facts

NPI
1962030627
Entity type
Organization (NPI type 2)
Primary specialty
Certified Registered Nurse Anesthetist 367500000X
Legal business name
3 PEAKS ANESTHESIA, INC
Practice address
2375 E Sunnyside Rd
Idaho Falls, ID 83404-8280
Phone
(208) 557-2767
NPI assigned
Mar 30, 2020
Organization subpart
No

Authorized official

Name
Henry Michael Adams, CRNA
Title
Owner
Phone
(208) 569-5698

Practitioners 1

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

Medicare participation

Medicare fee-for-service enrollment
Enrolled in ID

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20200526000597 ID Part B Supplier - Clinic/Group Practice 8325469513 Receives reassigned benefits from 1 practitioner
Practice locations: Idaho Falls, ID

National Provider Directory

Locations

3369 Merlin Dr
#A
Idaho Falls, ID 83404
Phone (208) 524-8351

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist
Group: 193400000X SINGLE SPECIALTY GROUP
367500000X Yes

Addresses

Primary practice location

2375 E Sunnyside Rd
Idaho Falls, ID 83404-8280

Mailing address

3555 Potomac Way
Idaho Falls, ID 83404-4985
Phone (208) 525-2090

Other providers in Idaho Falls, ID

All providers in Idaho Falls, ID · Certified Registered Nurse Anesthetist in Idaho

Sources for this page

Verify at the official NPI Registry.