Individual provider Active NPI

Robert Kinghorn, CRNA

  • Certified Registered Nurse Anesthetist
  • Twin Falls, ID
National Provider Identifier
1104905447
Registry record updated Jul 16, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
N-15840 Issued in ID
Practice address
115 Falls Ave W
Twin Falls, ID 83301-3115
Phone
(208) 734-7362
Fax
(208) 733-9463
NPI assigned
Nov 6, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 16, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X N-15840 ID Primary

Addresses

Primary practice location

115 Falls Ave W
Twin Falls, ID 83301-3115

Mailing address

PO Box 1657
Twin Falls, ID 83303-1657
Phone (208) 734-7362

Other identifiers 1

IdentifierTypeStateIssuer
004372800MedicaidID

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
N-15840IDMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Twin Falls Anesthesia Associates LLC Nurse Anesthetist, Certified Registered CurrentSince Nov 1, 2011 Accepting new patients
Idaho Anesthesia Nurse Anesthetist, Certified Registered Past Accepting new patients

Locations

115 Falls Ave W
Twin Falls, ID 83301
Phone (208) 732-8784

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1162771200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1405468800000",
    "number": "1104905447",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1657",
            "city": "TWIN FALLS",
            "state": "ID",
            "postal_code": "833031657",
            "telephone_number": "208-734-7362",
            "fax_number": "208-733-9463"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "115 FALLS AVE W",
            "city": "TWIN FALLS",
            "state": "ID",
            "postal_code": "833013115",
            "telephone_number": "208-734-7362",
            "fax_number": "208-733-9463"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KINGHORN",
        "first_name": "ROBERT",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-06",
        "last_updated": "2014-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "ID",
            "license": "N-15840",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004372800",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Twin Falls, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2014; 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.