Individual provider Active NPI

Daniel James Parker, CRNA

  • Certified Registered Nurse Anesthetist
  • Pocatello, ID
National Provider Identifier
1972917987
Registry record updated Mar 2, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
RNA-908A Issued in ID
Practice address
333 N 18TH Ave Ste a
Pocatello, ID 83201-3358
Phone
(208) 233-8880
NPI assigned
Jun 17, 2014
Last updated
Mar 2, 2022By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 2, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Care Medicine Registered Nurse 163WC0200X RN60263810 WA
Certified Registered Nurse Anesthetist 367500000X RNA-908A ID Primary

Addresses

Primary practice location

333 N 18TH Ave Ste a
Pocatello, ID 83201-3358

Mailing address

PO Box 4107
Pocatello, ID 83205-4107
Phone (208) 233-8880

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140916002953 ID Practitioner - Certified Registered Nurse Anesthetist (Crna) 5496974842 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Northstar Anesthesia of Idaho PLLCGroup PAC ID 6204283856, 37 clinicians

Practice addresses (Care Compare)

777 Hospital Way
Pocatello, ID 83201-5175
Phone (208) 239-1000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
RN60263810WAMDCritical Care Medicine Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Northstar Anesthesia of Idaho PLLC CurrentSince Oct 1, 2023 Accepting new patients

Locations

1151 Hospital Way
Bldg A
Pocatello, ID 83201
Phone (208) 232-6616

333 N 18th Ave
Ste C
Pocatello, ID 83201
Phone (208) 234-7800

777 Hospital Way
Pocatello, ID 83201
Phone (208) 239-1000

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1402963200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646179200000",
    "number": "1972917987",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4107",
            "city": "POCATELLO",
            "state": "ID",
            "postal_code": "832054107",
            "telephone_number": "208-233-8880"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "333 N 18TH AVE STE A",
            "city": "POCATELLO",
            "state": "ID",
            "postal_code": "832013358",
            "telephone_number": "208-233-8880"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARKER",
        "first_name": "DANIEL",
        "middle_name": "JAMES",
        "credential": "CRNA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-06-17",
        "last_updated": "2022-03-02",
        "certification_date": "2022-03-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WC0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Critical Care Medicine",
            "state": "WA",
            "license": "RN60263810",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "ID",
            "license": "RNA-908A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pocatello, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 2, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.