| Shad B Westover, CRNA | |
|
1717 Arlington Ave, Caldwell, ID 83605-4802 | |
| (208) 455-4009 | |
| Not Available |
| Full Name | Shad B Westover |
|---|---|
| Gender | Male |
| Speciality | Certified Registered Nurse Anesthetist (crna) |
| Experience | 19 Years |
| Location | 1717 Arlington Ave, Caldwell, Idaho |
| Accepts Medicare Assignments | May be. He may accept the Medicare-approved amount; you may be billed for more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1407031180 | NPI | - | NPPES |
| 8079285 | Medicaid | ID |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 367500000X | Nurse Anesthetist, Certified Registered | RNA714 (Idaho) | Primary |
| 367500000X | Nurse Anesthetist, Certified Registered | NA3614 (California) | Secondary |
| Facility Name | Location | Facility Type |
|---|---|---|
| West Valley Medical Center | Caldwell, ID | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| West Idaho Anesthesia, Llp | 9133343031 | 12 |
| West Idaho Anesthesia, Llp | 9133343031 | 12 |
| Entity Name | Walter Knox Memorial Hospital |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1063419018 PECOS PAC ID: 7012907785 Enrollment ID: O20040514000512 |
| Entity Name | West Idaho Anesthesia, Llp |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1871918318 PECOS PAC ID: 9133343031 Enrollment ID: O20140616001943 |
| Mailing Address | Practice Location Address |
|---|---|
| Shad B Westover, CRNA Po Box 3816, Idaho Falls, ID 83403-3816 Ph: (208) 552-8572 | Shad B Westover, CRNA 1717 Arlington Ave, Caldwell, ID 83605-4802 Ph: (208) 455-4009 |
Larry Edgerton, CRNA Nurse Anesthetist - CR Medicare: Not Enrolled in Medicare Practice Location: 1717 Arlington Ave, Caldwell, ID 83605 Phone: 208-455-3940 | |
Daniel Bonilla, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 1717 Arlington Ave, Caldwell, ID 83605 Phone: 208-459-4641 |