Trevor Drake (NPI# 1760884803, PAC ID# 3577881499) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is CERTIFIED REGISTERED NURSE ANESTHETIST (CRNA).
| Nation Provider ID (NPI) | 1760884803 |
| PAC ID by PECOS | 3577881499 |
| Professional Enrollment ID | I20150406000556 |
| Full Name | Trevor Drake |
| Organization Legal Name | INTERMOUNTAIN ANESTHESIA PA |
| Address |
3100 Channing Way Idaho Falls ID 83404-7533 |
| Phone Number | 2085296111 |
| Gender | M |
| Graduation Year | 2014 |
| Primary Specialty | CERTIFIED REGISTERED NURSE ANESTHETIST (CRNA) |
| Group Practice PAC ID | 5193638781 |
| Number of Group Practice Members | 28 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 130018 | EASTERN IDAHO REGIONAL MEDICAL CENTER |
| Address | Phone | Organization |
|---|---|---|
| 3100 Channing Way, Idaho Falls, ID 83404-7533 | 2085296111 | INTERMOUNTAIN ANESTHESIA PA |
| Organization Legal Name | INTERMOUNTAIN ANESTHESIA PA |
| Physicians | 23 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Reed D Loertscher | Certified Registered Nurse Anesthetist (crna) | Intermountain Anesthesia Pa | 3100 Channing Way, Idaho Falls, ID 83404-7533 |
| Lara K Knowles | Certified Registered Nurse Anesthetist (crna) | Intermountain Anesthesia Pa | 3100 Channing Way, Idaho Falls, ID 83404-7533 |
| Mikael B Crapo | Certified Registered Nurse Anesthetist (crna) | Intermountain Anesthesia Pa | 3100 Channing Way, Idaho Falls, ID 83404-7533 |
| Marc E Murphy | Anesthesiology | Intermountain Anesthesia Pa | 3100 Channing Way, Idaho Falls, ID 83404-7533 |
| Jay M Tingey | Anesthesiology | Intermountain Anesthesia Pa | 3100 Channing Way, Idaho Falls, ID 83404-7533 |
| Christian D Monson | Anesthesiology | Intermountain Anesthesia Pa | 3100 Channing Way, Idaho Falls, ID 83404-7533 |
| Douglas G Jex | Certified Registered Nurse Anesthetist (crna) | Intermountain Anesthesia Pa | 3100 Channing Way, Idaho Falls, ID 83404-7533 |
| Jacob L Rowberry | Certified Registered Nurse Anesthetist (crna) | Intermountain Anesthesia Pa | 3100 Channing Way, Idaho Falls, ID 83404-7533 |
| Michael S Mickelsen | Certified Registered Nurse Anesthetist (crna) | Intermountain Anesthesia Pa | 3100 Channing Way, Idaho Falls, ID 83404-7533 |
| Jeffrey L Taylor | Certified Registered Nurse Anesthetist (crna) | Intermountain Anesthesia Pa | 3100 Channing Way, Idaho Falls, ID 83404-7533 |
| Street Address |
3100 CHANNING WAY |
| City | IDAHO FALLS |
| State | ID |
| Zip | 83404-7533 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Reed D Loertscher | Certified Registered Nurse Anesthetist (crna) | Intermountain Anesthesia Pa | 3100 Channing Way, Idaho Falls, ID 83404-7533 |
| Lara K Knowles | Certified Registered Nurse Anesthetist (crna) | Intermountain Anesthesia Pa | 3100 Channing Way, Idaho Falls, ID 83404-7533 |
| Sean D Anderson | Physical Medicine and Rehabilitation | Eirmc Hospitalist Services LLC | 3100 Channing Way, Idaho Falls, ID 83404-7533 |
| Mikael B Crapo | Certified Registered Nurse Anesthetist (crna) | Intermountain Anesthesia Pa | 3100 Channing Way, Idaho Falls, ID 83404-7533 |
| Matt Tannenbaum | Pathology | Pathology Associates of Idaho Falls | 3100 Channing Way, Idaho Falls, ID 83404-7533 |
| Shawn Douglas Speirs | Internal Medicine | 3100 Channing Way, Idaho Falls, ID 83404-7533 | |
| Steven Chase Cook | Nurse Practitioner | Burn and Reconstructive Centers of Idaho Pllc | 3100 Channing Way, Idaho Falls, ID 83404-7533 |
| Marc E Murphy | Anesthesiology | Intermountain Anesthesia Pa | 3100 Channing Way, Idaho Falls, ID 83404-7533 |
| Jay M Tingey | Anesthesiology | Intermountain Anesthesia Pa | 3100 Channing Way, Idaho Falls, ID 83404-7533 |
| Clark Rainey Daines | Pathology | Pathology Associates of Idaho Falls | 3100 Channing Way, Idaho Falls, ID 83404-7533 |
| Find all physicians in the same address | |||
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Elizabeth Ann Sharp-marsden | Nurse Practitioner | 1680 Elk Creek Dr, Idaho Falls, ID 83404-1225 | |
| Lisa Hong | Occupational Therapy | Foothills Rehabilitation and Performance Services Pllc | 3715 Woodking Dr, Idaho Falls, ID 83404-4720 |
| Brent Kennedy | Physical Therapy | Foothills Rehabilitation and Performance Services Pllc | 3715 Woodking Dr, Idaho Falls, ID 83404-4720 |
| Heidi Duran | Physical Therapy | Foothills Rehabilitation and Performance Services Pllc | 3715 Woodking Dr, Idaho Falls, ID 83404-4720 |
| Rebecca L Butikofer | Occupational Therapy | Foothills Rehabilitation and Performance Services Pllc | 3715 Woodking Dr, Idaho Falls, ID 83404-4720 |
| Kristan Bullock | Qualified Speech Language Pathologist | Foothills Rehabilitation and Performance Services Pllc | 3715 Woodking Dr, Idaho Falls, ID 83404-4720 |
| Dawn Taylor | Qualified Speech Language Pathologist | Foothills Rehabilitation and Performance Services Pllc | 3715 Woodking Dr, Idaho Falls, ID 83404-4720 |
| Brenda Padron | Qualified Speech Language Pathologist | Foothills Rehabilitation and Performance Services Pllc | 3715 Woodking Dr, Idaho Falls, ID 83404-4720 |
| Kimberly Stowell | Qualified Speech Language Pathologist | Foothills Rehabilitation and Performance Services Pllc | 3715 Woodking Dr, Idaho Falls, ID 83404-4720 |
| Michael Anderson | Physical Therapy | Foothills Rehabilitation and Performance Services Pllc | 3715 Woodking Dr, Idaho Falls, ID 83404-4720 |
| Find all physicians in zip 83404 | |||
| City | IDAHO FALLS |
| Zip Code | 83404 |
| Specialty | CERTIFIED REGISTERED NURSE ANESTHETIST (CRNA) |
| City + Specialty | IDAHO FALLS + CERTIFIED REGISTERED NURSE ANESTHETIST (CRNA) |
Please comment or provide details below to improve the information on Trevor Drake.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.