| Samuel Hayward Ellison, CRNA | |
|
2003 Kootenai Health Way, Coeur D Alene, ID 83814-6051 | |
| (509) 432-4529 | |
| (208) 765-8486 |
| Full Name | Samuel Hayward Ellison |
|---|---|
| Gender | Male |
| Speciality | Certified Registered Nurse Anesthetist (crna) |
| Experience | 3 Years |
| Location | 2003 Kootenai Health Way, Coeur D Alene, Idaho |
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1811627250 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 367500000X | Nurse Anesthetist, Certified Registered | 43-557976-071 (Kansas) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Kootenai Health | Coeur d'alene, ID | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Anesthesia Associates Of Coeur D Alene Pllc | 2365427838 | 49 |
| Shoshone Medical Center | 6103739107 | 25 |
| Entity Name | Anesthesia Associates Of Coeur D Alene Pllc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1962440966 PECOS PAC ID: 2365427838 Enrollment ID: O20040621000475 |
| Entity Name | Shoshone Medical Center |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1043215437 PECOS PAC ID: 6103739107 Enrollment ID: O20050113001084 |
| Entity Name | Shoshone Medical Center |
|---|---|
| Entity Type | Part A Provider - Critical Access Hospital |
| Entity Identifiers | NPI Number: 1043215437 PECOS PAC ID: 6103739107 Enrollment ID: O20061104000442 |
| Mailing Address | Practice Location Address |
|---|---|
| Samuel Hayward Ellison, CRNA 1028 Compton Ct, Moscow, ID 83843-8531 Ph: (509) 432-4529 | Samuel Hayward Ellison, CRNA 2003 Kootenai Health Way, Coeur D Alene, ID 83814-6051 Ph: (509) 432-4529 |
Joshua Leppert, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 2003 Kootenai Health Way, Coeur D Alene, ID 83814 Phone: 208-765-8585 | |
Ms. Nuria M Martinez, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 2204 Ironwood Pl Ste B, Coeur D Alene, ID 83814 Phone: 208-765-8585 | |
Ryan C Golob, CRNA Nurse Anesthetist - CR Medicare: Medicare Enrolled Practice Location: 2003 Kootenai Health Way, Coeur D Alene, ID 83814 Phone: 208-666-2000 | |
Kevin M Knopp, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 2003 Kootenai Health Way, Coeur D Alene, ID 83814 Phone: 208-625-4000 | |
Richard J Gerhard, CRNA Nurse Anesthetist - CR Medicare: Medicare Enrolled Practice Location: 1705 N Government Way, Coeur D Alene, ID 83814 Phone: 208-765-8585 Fax: 208-765-8486 | |
Joanna M Minetti, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 101 W Ironwood Dr Ste 250, Coeur D Alene, ID 83814 Phone: 208-765-8585 | |
Trent Munyer, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 3696 E Sky Harbor Dr, Coeur D Alene, ID 83814 Phone: 208-818-5273 |