| Travis Henderson, CRNA | |
|
1717 Arlington Ave, Caldwell, ID 83605-4802 | |
| (208) 459-4641 | |
| Not Available |
| Full Name | Travis Henderson |
|---|---|
| Gender | Male |
| Speciality | Certified Registered Nurse Anesthetist (crna) |
| Experience | 9 Years |
| Location | 1717 Arlington Ave, Caldwell, 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 |
|---|---|---|---|
| 1093258386 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 163W00000X | Registered Nurse | 41135 (Idaho) | Secondary |
| 367500000X | Nurse Anesthetist, Certified Registered | 112038 (Idaho) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| West Valley Medical Center | Caldwell, ID | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Anesthesia Consulting Partners Idaho Pc | 5092164806 | 10 |
| Entity Name | Boise Anesthesia, P A |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1487602298 PECOS PAC ID: 8426960642 Enrollment ID: O20031105000132 |
| Entity Name | Anesthesia Consulting Partners Idaho Pc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1568241362 PECOS PAC ID: 5092164806 Enrollment ID: O20231205002846 |
| Mailing Address | Practice Location Address |
|---|---|
| Travis Henderson, CRNA 6452 E Shellbrook Dr, Nampa, ID 83687-4126 Ph: () - | Travis Henderson, CRNA 1717 Arlington Ave, Caldwell, ID 83605-4802 Ph: (208) 459-4641 |
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 | |
Shad B Westover, CRNA Nurse Anesthetist - CR Medicare: May Accept Medicare Assignments Practice Location: 1717 Arlington Ave, Caldwell, ID 83605 Phone: 208-455-4009 |