NPIMap

Organization Active NPI

Innovative Anesthesia Pain & Wellness PLLC

  • Certified Registered Nurse Anesthetist
  • Meridian, ID
National Provider Identifier
1962385948
Registry record updated Jul 28, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
Legal business name
INNOVATIVE ANESTHESIA PAIN & WELLNESS PLLC
Practice address
3090 E Gentry Way Ste 100
Meridian, ID 83642-3548
Phone
(208) 288-1600
NPI assigned
Jul 28, 2025
Last updated
Jul 28, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 28, 2025

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

Authorized official

Name
Michael Hunt, CRNANPI 1760786362
Title
Owner
Phone
(801) 372-5785

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

3090 E Gentry Way Ste 100
Meridian, ID 83642-3548

Mailing address

PO Box 2472
Idaho Falls, ID 83403-2472
Phone (800) 338-5378

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ID

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20251015000824 ID Part B Supplier - Clinic/Group Practice 7214336882 Receives reassigned benefits from 12 practitioners
Practice locations: Meridian, ID

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 12

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.

NPI Registry JSON

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

{
    "created_epoch": "1753660800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1753660800000",
    "number": "1962385948",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2472",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834032472",
            "telephone_number": "800-338-5378",
            "fax_number": "208-523-8978"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3090 E GENTRY WAY STE 100",
            "city": "MERIDIAN",
            "state": "ID",
            "postal_code": "836423548",
            "telephone_number": "208-288-1600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INNOVATIVE ANESTHESIA PAIN & WELLNESS PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-07-28",
        "last_updated": "2025-07-28",
        "certification_date": "2025-07-28",
        "status": "A",
        "authorized_official_last_name": "HUNT",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "801-372-5785",
        "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 Meridian, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 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.