Individual provider Active NPI

Jennifer Ann Boyer, CRNA

  • Certified Registered Nurse Anesthetist
  • Polson, MT
National Provider Identifier
1205933959
Registry record updated May 14, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
100911 Issued in MT
Practice address
6 13TH Ave E
Polson, MT 59860
Phone
(406) 883-5680
Fax
(406) 883-8910
NPI assigned
Sep 17, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 14, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 16701 ID
Certified Registered Nurse Anesthetist 367500000X 100911 MT Primary

Addresses

Primary practice location

6 13TH Ave E
Polson, MT 59860

Mailing address

6 13TH Ave E
Polson, MT 59860-5315
Phone (406) 883-5680

Other practice location 1

106 Ridgewater Dr
Suite B
Polson, MT 59860-8977
Phone (406) 883-7709

Other identifiers 1

IdentifierTypeStateIssuer
807572000MedicaidWA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080807000418 MT Practitioner - Certified Registered Nurse Anesthetist (Crna) 9537160502 Reassigns benefits to 5 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
16701IDMDCertified Registered Nurse Anesthetist
100911MTMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Marcus Daly Memorial Hospital Corporation CurrentSince Dec 9, 2019 Accepting new patients
Marcus Daly Memorial Hospital Corporation CurrentSince Dec 9, 2019 Accepting new patients
M & M Anesthesia Services, LLC Nurse Anesthetist, Certified Registered CurrentSince May 1, 2020 Accepting new patients
Butte Pain and Anesthesia Associates, PLLC CurrentSince Feb 1, 2011 Accepting new patients
Missoula Community Health Services, Inc. CurrentSince Oct 1, 2019 Accepting new patients
Missoula Community Health Services, Inc. CurrentSince Oct 1, 2019 Accepting new patients
Community Hospital of Anaconda Current Accepting new patients
Capital Medical Anesthesia PLLP Nurse Anesthetist, Certified Registered Past Accepting new patients
Powell County Memorial Hospital Association Inc Past Accepting new patients
Interventional Pain Consultants PA Past Accepting new patients

Locations

400 10th St E
Waconia, MN 55387

401 W Pennsylvania Ave
Anaconda, MT 59711
Phone (406) 563-5261

305 W Pennsylvania Ave
Anaconda, MT 59711
Phone (406) 563-8571

400 S Clark St
Butte, MT 59701
Phone (406) 495-7260

1224 W Main St
Hamilton, MT 59840
Phone (406) 375-4823

1200 Westwood Dr
Hamilton, MT 59840
Phone (406) 363-2211

1930 W Broadway St
Ste B
Missoula, MT 59808
Phone (406) 541-6836

700 W Kent Ave
Missoula, MT 59801
Phone (406) 541-3277

1208 6th Ave
Superior, MT 59872
Phone (406) 683-3401

Organizations & group practices 10

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": "1158451200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1557792000000",
    "number": "1205933959",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6 13TH AVE E",
            "city": "POLSON",
            "state": "MT",
            "postal_code": "598605315",
            "telephone_number": "406-883-5680",
            "fax_number": "406-883-8910"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6 13TH AVE E",
            "city": "POLSON",
            "state": "MT",
            "postal_code": "59860",
            "telephone_number": "406-883-5680",
            "fax_number": "406-883-8910"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "106 Ridgewater Dr",
            "address_2": "Suite B",
            "address_purpose": "LOCATION",
            "city": "Polson",
            "state": "MT",
            "postal_code": "598608977",
            "country_code": "US",
            "telephone_number": "406-883-7709",
            "fax_number": "406-883-2042",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BOYER",
        "first_name": "JENNIFER",
        "middle_name": "ANN",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-17",
        "last_updated": "2019-05-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "ID",
            "license": "16701",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MT",
            "license": "100911",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "807572000",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Polson, MT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 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.