NPIMap

Organization Active NPI

Anesthesiology Consultants of Idaho PA

  • Anesthesiology Physician
  • Nampa, ID
National Provider Identifier
1093703340
Registry record updated Jul 18, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
C122890 Issued in ID
Legal business name
ANESTHESIOLOGY CONSULTANTS OF IDAHO PA
Practice address
1512 12TH Ave Rd
Nampa, ID 83686-6008
Phone
(208) 463-5029
NPI assigned
Oct 11, 2005
Last updated
Jul 18, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 18, 2012

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Steve RobertsNPI 1013905355
Title
MD/Officer
Phone
(208) 463-5029

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X C122890 ID Primary

Addresses

Primary practice location

1512 12TH Ave Rd
Nampa, ID 83686-6008

Mailing address

104 W 5TH Ave
Suite 250E
Spokane, WA 99204-4880
Phone (866) 263-1223

Other identifiers 4

IdentifierTypeStateIssuer
0207MedicaidOR
805239900MedicaidID
8052399MedicaidID
8082399MedicaidID

National Provider Directory

National Provider Directory

Locations

104 W 5th Ave
Ste 250E
Spokane, WA 99204
Phone (509) 838-1547

Practitioners & affiliated clinicians

Practitioners 13

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 13

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1128988800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1342569600000",
    "number": "1093703340",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "104 W 5TH AVE",
            "address_2": "SUITE 250E",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992044880",
            "telephone_number": "866-263-1223",
            "fax_number": "509-835-4058"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1512 12TH AVE RD",
            "city": "NAMPA",
            "state": "ID",
            "postal_code": "836866008",
            "telephone_number": "208-463-5029"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ANESTHESIOLOGY CONSULTANTS OF IDAHO PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-10-11",
        "last_updated": "2012-07-18",
        "status": "A",
        "authorized_official_last_name": "ROBERTS",
        "authorized_official_first_name": "STEVE",
        "authorized_official_title_or_position": "MD/OFFICER",
        "authorized_official_telephone_number": "208-463-5029",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "ID",
            "license": "C122890",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0207",
            "state": "OR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "805239900",
            "state": "ID"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8052399",
            "state": "ID"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8082399",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Nampa, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.