Individual provider Active NPI

Jeremy Charles Bates

  • Certified Registered Nurse Anesthetist
  • Boise, ID
National Provider Identifier
1245669324
Registry record updated Jan 17, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
RNA-892A Issued in ID
Practice address
338 E Bannock St
Boise, ID 83712-6207
Phone
(208) 336-0895
NPI assigned
Nov 8, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 17, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 41433 ID
Certified Registered Nurse Anesthetist 367500000X RNA-892A ID Primary

Addresses

Primary practice location

338 E Bannock St
Boise, ID 83712-6207

Mailing address

1847 W Whitestone CT
Meridian, ID 83646-1308
Phone (208) 680-5168

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140417002018 ID Practitioner - Certified Registered Nurse Anesthetist (Crna) 0749412146 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Anesthesia Associates of Boise, P.a.Group PAC ID 2668385287, 183 clinicians

Practice addresses (Care Compare)

1000 State St
McCall, ID 83638-3704
Phone (208) 634-2221

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Intermountain Ambulatory Anesthesia PLLC Nurse Anesthetist, Certified Registered CurrentSince May 1, 2021 Accepting new patients
Anesthesia Associates of Boise, P.a. CurrentSince Feb 13, 2014 Accepting new patients

Locations

190 E Bannock St
Boise, ID 83712
Phone (208) 381-2378

338 E Bannock St
Boise, ID 83712
Phone (208) 336-0895

600 N Robbins Rd
Ste 401
Boise, ID 83702
Phone (208) 489-4279

2537 W State St
Ste 200
Boise, ID 83702
Phone (208) 336-0895

1000 State St
McCall, ID 83638
Phone (208) 634-2221

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1383868800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1579219200000",
    "number": "1245669324",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1847 W WHITESTONE CT",
            "city": "MERIDIAN",
            "state": "ID",
            "postal_code": "836461308",
            "telephone_number": "208-680-5168"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "338 E BANNOCK ST",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837126207",
            "telephone_number": "208-336-0895"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BATES",
        "first_name": "JEREMY",
        "middle_name": "CHARLES",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-11-08",
        "last_updated": "2020-01-17",
        "certification_date": "2020-01-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "ID",
            "license": "41433",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "ID",
            "license": "RNA-892A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boise, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 17, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.