NPI age
18 years
Enumerated 2008-04-15
● Active Type 2 · Organization
Subpart
Minidoka Memorial Hospital CRNA Group
Minidoka Memorial Hospital CRNA Group is 1 of 575 nurse anesthetist, certified registered organizations in Idaho.
Primary specialty
Nurse Anesthetist, Certified Registered
Practice locations
1
0 secondary on file
Status
Active
No deactivations on record
Authorized official
Hansen
Administrator
Last NPPES update
2011-10-03
Source: monthly bulk 2026-05
How this organization compares
Across 575 active nurse anesthetist, certified registered providers in Idaho.
NPI age
18 years
↑ 3 yr above median
Practice locations
1
0 secondary on file
Subspecialties
0
NPI lifetime · 2008 → 2026
2008-04Enumerated in NPPES
2008
2026
Where they practice
Primary practice location
1224 8th St
Rupert, ID 833501527
Mailing address
1224 8th St
Rupert, ID 833501527
Authorized official
Carl Hansen
Administrator
📞 2084360481
Individual providers at this organization
15 individual providers on file at this primary practice address.
- Jessica Bagby, MD Emergency Medicine NPI 1093161473
- Jeffery Baldwin, P.T. Physical Therapist NPI 1205855202
- Scott Bloxham, P.T. Physical Therapist NPI 1962488205
- Charles Clair, MD Family Medicine NPI 1003012204
- Rachel Durrant, MS, CCC-SLP Speech-Language Pathologist NPI 1215432984
- Benjamin Guercio, CRNA Nurse Anesthetist, Certified Registered NPI 1972763381
- Maria Hernandez, P.T. Physical Therapist NPI 1730104597
- Lori Johnson, R.D.,L.D Dietitian, Registered NPI 1669578472
- Donald Konrad, D.O. Family Medicine NPI 1306836077
- Brandon Madsen, CRNA Nurse Anesthetist, Certified Registered NPI 1265037741
- Davee Mussmann, DPT Physical Therapist NPI 1144202938
- William Robar, DO Emergency Medicine NPI 1225560444
- Allison Serr, FNP-C Nurse Practitioner NPI 1144933912
- David Wageman, DO Emergency Medicine NPI 1528108867
- David Ward, PHARMD Pharmacist NPI 1851477863
Specialties
-
Nurse Anesthetist, Certified Registered Primary(1) A licensed registered nurse with advanced specialty education in anesthesia who, in collaboration with appropriate health care professionals, provides preoperative, intraoperative, and postoperative care to patients and assists in...
Identifiers
| Type | Value | Notes |
|---|---|---|
| 01 | 002336000 | BLUE SHIELD |
| 05 (ID) | M8068633 | |
| 01 | 00166 | BLUE CROSS OF IDAHO |
Practice context
Multi-provider organization. 15 individual providers on file at this primary address.
Subpart of Minidoka Memorial Hospital.
Provyx · Custom healthcare lists
Need all 575 Nurse Anesthetist, Certified Registered providers in Idaho?
Provyx verifies the list to your scope. Business emails and direct lines are looked up at delivery, validated, and not stored.
Request a quote →How to verify this organization
- Confirm the NPI on NPPES.The CMS registry is the system of record. Open NPPES →
- Verify the organization is in good standing.Cross-check with the state's business registration and any applicable licensing boards.
- Confirm payer enrollment if billing.NPI presence does not guarantee active enrollment with Medicare, Medicaid, or commercial payers.