Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Grant Gundersen, CNRA

Individual provider Certified Registered Nurse Anesthetist · NPI 1467863829

Grant Gundersen, CNRA is a Certified Registered Nurse Anesthetist (CRNA) in Blackfoot, Idaho. Qualified in 2012, 14 years ago. Practices with St Alphonsus Professional Medical Services LLC, a 123-clinician group and accepts Medicare assignment. Licensed in Idaho.

Years since qualifying
14
Licensed in
ID
In the registry since
2014
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Practice location Address checks out

646 W 300 S
Blackfoot, ID 83221-6334
Phone: (208) 760-7529
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Certified Registered Nurse Anesthetist (primary) Taxonomy 367500000X · Licence N-38994 (ID)

Record details

NPI number1467863829
Entity typeIndividual (Type 1)
GenderMale
Credentials CNRA
Sole proprietorNo
NPI enumeratedMay 19, 2014
Last updated in NPPESMay 19, 2014
Mailing address646 W 300 S, Blackfoot, ID 83221-6334

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyCERTIFIED REGISTERED NURSE ANESTHETIST (CRNA)
Medical schoolOTHER
Graduated 2012 (14 years in practice)
Group practice St Alphonsus Professional Medical Services Llc — 123 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

Other providers in Blackfoot