Active NPI
Loren Ken Zeitz, CRNA
- Certified Registered Nurse Anesthetist
- Kellogg, ID
National Provider Identifier
1285677278
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Certified Registered Nurse Anesthetist
- License
- N-10526
- Practice address
- 25 Jacobs Gulch
Kellogg, ID 83837 - Phone
- (208) 784-1221
- Fax
- (208) 786-1019
- NPI assigned
- Jun 14, 2006
- Last updated
- Jun 14, 2011
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Certified Registered Nurse Anesthetist | 367500000X | N-10526 | ID | Primary |
| Anesthesiology Physician | 207L00000X | RNA68 | ID |
Addresses
Primary practice location
25 Jacobs Gulch
Kellogg, ID 83837
Mailing address
25 Jacobs Gulch
Kellogg, ID 83837
Phone (208) 784-1221
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 8040130300 | Medicaid | ID | |
| N-10526 | Other | ID | IDAHO LICENSE |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RNA68 | ID | MD | Anesthesiology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1150243200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1308009600000",
"number": "1285677278",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "25 JACOBS GULCH",
"city": "KELLOGG",
"state": "ID",
"postal_code": "83837",
"telephone_number": "208-784-1221",
"fax_number": "208-786-7019"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "25 JACOBS GULCH",
"city": "KELLOGG",
"state": "ID",
"postal_code": "83837",
"telephone_number": "208-784-1221",
"fax_number": "208-786-1019"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ZEITZ",
"first_name": "LOREN",
"middle_name": "KEN",
"name_prefix": "Mr.",
"credential": "CRNA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-06-14",
"last_updated": "2011-06-14",
"status": "A"
},
"taxonomies": [
{
"code": "367500000X",
"taxonomy_group": "",
"desc": "Nurse Anesthetist, Certified Registered",
"state": "ID",
"license": "N-10526",
"primary": true
},
{
"code": "207L00000X",
"taxonomy_group": "",
"desc": "Anesthesiology",
"state": "ID",
"license": "RNA68",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "8040130300",
"state": "ID"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "IDAHO LICENSE",
"identifier": "N-10526",
"state": "ID"
}
],
"endpoints": [],
"other_names": []
}Other providers in Kellogg, ID
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.