Active NPI
Charlene Surbaugh, R.N., F.A.
- Registered Nurse
- Twin Falls, ID
National Provider Identifier
1275685356
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Nurse
- License
- N14523
- Practice address
- 562 Shoup Ave W
Twin Falls, ID 83301-5029 - Phone
- (208) 734-3455
- Fax
- (208) 733-7389
- NPI assigned
- Jan 17, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | N14523 | ID | Primary |
Addresses
Primary practice location
562 Shoup Ave W
Twin Falls, ID 83301-5029
Mailing address
PO Box 1808
Twin Falls, ID 83303-1808
Phone (208) 734-3455
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)
- Not enrolled
- Credentials
- Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| N14523 | ID | MD | Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1168992000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1275685356",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1808",
"city": "TWIN FALLS",
"state": "ID",
"postal_code": "833031808",
"telephone_number": "208-734-3455",
"fax_number": "208-733-7389"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "562 SHOUP AVE W",
"city": "TWIN FALLS",
"state": "ID",
"postal_code": "833015029",
"telephone_number": "208-734-3455",
"fax_number": "208-733-7389"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SURBAUGH",
"first_name": "CHARLENE",
"credential": "R.N., F.A.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-01-17",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "ID",
"license": "N14523",
"primary": true
}
],
"identifiers": [],
"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 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.