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

Tavish Ronald Nelson, CRNA

Individual provider Certified Registered Nurse Anesthetist · NPI 1679215958

Tavish Ronald Nelson, CRNA is a Certified Registered Nurse Anesthetist (CRNA) in Pocatello, Idaho. Qualified in 2025, 1 year ago. Practices with Northstar Anesthesia of Idaho PLLC, a 39-clinician group and accepts Medicare assignment. Licensed in Utah.

Years since qualifying
1
Licensed in
UT
In the registry since
2022
What do these letters mean?
CRNA — Certified Registered Nurse Anesthetist
An advanced practice nurse who administers anaesthesia.

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Practice location Address checks out

777 Hospital Way
Pocatello, ID 83201-5175
Phone: (208) 239-1000
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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 153255 (UT)

Record details

NPI number1679215958
Entity typeIndividual (Type 1)
GenderMale
Credentials CRNA
Sole proprietorNo
NPI enumeratedApril 8, 2022
Last updated in NPPESMay 15, 2025
Certification dateMay 15, 2025

Medicare enrollment

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

Medicare specialtyCERTIFIED REGISTERED NURSE ANESTHETIST (CRNA)
Medical schoolOTHER
Graduated 2025 (1 years in practice)
Group practice Northstar Anesthesia Of Idaho Pllc — 39 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

Other providers in Pocatello