NPIMap

Organization Active NPI

Bruce Demko Crna Inc

  • Certified Registered Nurse Anesthetist
  • Ponderay, ID
National Provider Identifier
1376713008
Registry record updated Jan 4, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
RNA491A Issued in ID
Legal business name
BRUCE DEMKO CRNA INC
Practice address
30544 Highway 200
Ponderay, ID 83852-5005
Phone
(208) 255-8013
NPI assigned
Mar 10, 2008
Last updated
Jan 4, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 4, 2013

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

Authorized official

Name
Bruce Demko, CRNANPI 1780651539
Title
Self Owner
Phone
(208) 255-8013

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X RNA491A ID Primary

Addresses

Primary practice location

30544 Highway 200
Ponderay, ID 83852-5005

Mailing address

PO Box 591
Sagle, ID 83860
Phone (208) 265-3534

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1205107200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1357257600000",
    "number": "1376713008",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 591",
            "city": "SAGLE",
            "state": "ID",
            "postal_code": "83860",
            "telephone_number": "208-265-3534",
            "fax_number": "208-265-3534"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30544 HIGHWAY 200",
            "city": "PONDERAY",
            "state": "ID",
            "postal_code": "838525005",
            "telephone_number": "208-255-8013"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRUCE DEMKO CRNA INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-03-10",
        "last_updated": "2013-01-04",
        "status": "A",
        "authorized_official_last_name": "DEMKO",
        "authorized_official_first_name": "BRUCE",
        "authorized_official_title_or_position": "SELF OWNER",
        "authorized_official_telephone_number": "208-255-8013",
        "authorized_official_credential": "CRNA"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "ID",
            "license": "RNA491A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ponderay, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.