Active NPI
Rocky N Vulgamore
- Certified Registered Nurse Anesthetist
- Boise, ID
National Provider Identifier
1326155698
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Certified Registered Nurse Anesthetist
- License
- RNA-363
- Practice address
- 5583 N Crimson Way
Boise, ID 83703-2840 - Phone
- (208) 866-5026
- NPI assigned
- Aug 24, 2006
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Certified Registered Nurse Anesthetist | 367500000X | RNA-363 | ID | Primary |
Addresses
Primary practice location
5583 N Crimson Way
Boise, ID 83703-2840
Mailing address
5583 N Crimson Way
Boise, ID 83703-2840
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 805574900 | Medicaid | ID |
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
- HHS exclusion list flag
- Flagged The directory lists this NPI on an HHS exclusion list.
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RNA-363 | ID | MD | Certified Registered Nurse Anesthetist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Anesthesia Associates of Boise, P.a. | Past | Accepting new patients | |
| Lander Valley Physician Practices, LLC | Past | Accepting new patients | |
| Healing Arts Day Surgery LLC | Past | Accepting new patients |
Organizations & group practices 3
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.
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NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156377600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1244678400000",
"number": "1326155698",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5583 N CRIMSON WAY",
"city": "BOISE",
"state": "ID",
"postal_code": "837032840"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5583 N CRIMSON WAY",
"city": "BOISE",
"state": "ID",
"postal_code": "837032840",
"telephone_number": "208-866-5026"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VULGAMORE",
"first_name": "ROCKY",
"middle_name": "N",
"name_prefix": "Mr.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-08-24",
"last_updated": "2009-06-11",
"status": "A"
},
"taxonomies": [
{
"code": "367500000X",
"taxonomy_group": "",
"desc": "Nurse Anesthetist, Certified Registered",
"state": "ID",
"license": "RNA-363",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "805574900",
"state": "ID"
}
],
"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 Jun 11, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.