GARY R JOHANSON (CRNA) – Certified Registered Nurse Anesthetist, NPI 1700836418

Certified Registered Nurse Anesthetist

GARY R JOHANSON (CRNA) is a healthcare provider. based in Pocatello, Idaho. specializing in Certified Registered Nurse Anesthetist. They hold the professional credentials CRNA. They hold a License No. N15687 (ID). The NPI Number for GARY R JOHANSON (CRNA) is 1700836418

Main info

Male

48 Years Of Experience

Accepts Medicare Assignment

Name

GARY R JOHANSON (CRNA)

NPI

1700836418

Phone

(208) 232-7760

Address

PO BOX 4107

Enumeration Date

11 May 2006

Last Update Date

19 October 2011

Doctor Profile

Medical School Name

OTHER

Secondary Phone

2082338880

Graduation Year

1978 (48 years ago)

PAC ID

9234321969

Group Practice PAC ID

4183849979

Professional Enrollment ID

I20101013000090

Data current as of

19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology

Experience63

Completeness75

Years active:20State licenses:2Digital endpointsOther names

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Provider Addresses for GARY R JOHANSON (CRNA)

PO BOX 4107
POCATELLO, ID 832054107
Phone: (208) 232-7760
Fax: (208) 232-1950
Type: Mailing
1950, East Clark Street, Pocatello, Bannock County, Idaho, 83201, United States
SUITE G
POCATELLO, ID 832013314
Phone: (208) 232-7760
Fax: (208) 232-1950
Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

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Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

No Medicare enrollment or revalidation data available for this provider in our database.

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Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 83205)

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Provider's Procedures

GARY R JOHANSON (CRNA) performs procedures in Certified Registered Nurse Anesthetist. See the list of HCPCS codes below.

Specialty	Practice State	HCPCS Code	Description	Service Count	Beneficiary Count
CERTIFIED REGISTERED NURSE ANESTHET	ID	01402	Anesthesia for open or endoscopic total knee joint replacement	12	12
CERTIFIED REGISTERED NURSE ANESTHET	ID	76942	Ultrasonic guidance imaging supervision and interpretation for insertion of needle	20	20

Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.

PAC ID: 4183849979View full group profile

Name	Specialty	State
MR. BENSON S ROPER (CRNA)	-	ID

Reviews

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Frequently asked questions

Where can patients find GARY R JOHANSON (CRNA)'s NPI?

You can confirm GARY R JOHANSON (CRNA) with NPI 1700836418; it appears in the national provider directory.

Is GARY R JOHANSON (CRNA)'s enrollment marked active?

An active flag here means the NPI record is not in a deactivated state.

Can you summarize GARY R JOHANSON (CRNA)'s specialty in plain language?

Clinically, the directory lists GARY R JOHANSON (CRNA) with Certified Registered Nurse Anesthetist. Clinical services aligned with this taxonomy classification.

What location shows for GARY R JOHANSON (CRNA)?

We surface Pocatello, Idaho for GARY R JOHANSON (CRNA) based on available NPPES addresses.

Is this NPI for an individual or an organization?

This listing corresponds to an Individual Provider.