NPIMap

Organization Active NPI

River City Anesthesia Associates, PLLC

  • Certified Registered Nurse Anesthetist
  • Post Falls, ID
National Provider Identifier
1114908993
Registry record updated Nov 13, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
Legal business name
RIVER CITY ANESTHESIA ASSOCIATES, PLLC
Practice address
1593 E Polston Ave
Post Falls, ID 83854-5326
Phone
(208) 262-2314
Fax
(208) 262-2394
NPI assigned
Nov 9, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 13, 2019

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

Authorized official

Name
Michelle Brinkley
Title
Office Manager
Phone
(208) 457-7067

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse AnesthetistGroup: 193400000X SINGLE SPECIALTY GROUP 367500000X Primary

Addresses

Primary practice location

1593 E Polston Ave
Post Falls, ID 83854-5326

Mailing address

1581 E Edmondton Ave Ste 204
Post Falls, ID 83854-6188
Phone (208) 457-7067

Other identifiers 1

IdentifierTypeStateIssuer
806674900MedicaidID

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ID

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040319001270 ID Part B Supplier - Clinic/Group Practice 4385534445 Receives reassigned benefits from 31 practitioners
Practice locations: Post Falls, ID

National Provider Directory

National Provider Directory

Locations

1581 E Edmondton Ave
Ste 204
Post Falls, ID 83854

Practitioners & affiliated clinicians

Practitioners 36

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 36

NPI Registry JSON

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

{
    "created_epoch": "1131494400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1573603200000",
    "number": "1114908993",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1581 E EDMONDTON AVE STE 204",
            "city": "POST FALLS",
            "state": "ID",
            "postal_code": "838546188",
            "telephone_number": "208-457-7067",
            "fax_number": "208-618-2185"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1593 E POLSTON AVE",
            "city": "POST FALLS",
            "state": "ID",
            "postal_code": "838545326",
            "telephone_number": "208-262-2314",
            "fax_number": "208-262-2394"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RIVER CITY ANESTHESIA ASSOCIATES, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-11-09",
        "last_updated": "2019-11-13",
        "status": "A",
        "authorized_official_last_name": "BRINKLEY",
        "authorized_official_first_name": "MICHELLE",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "208-457-7067"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "806674900",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Post Falls, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.