Individual provider Active NPI

Jessica L Reid, CRNA

  • Certified Registered Nurse Anesthetist
  • Boise, ID
National Provider Identifier
1386077220
Registry record updated Jan 21, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
RNA886A Issued in ID
Practice address
1055 N Curtis Rd
Boise, ID 83706-1309
Phone
(208) 367-6416
NPI assigned
Aug 14, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 21, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X RNA886A ID Primary

Addresses

Primary practice location

1055 N Curtis Rd
Boise, ID 83706-1309

Mailing address

PO Box 4268
Portland, OR 97208-4268
Phone (503) 372-2740

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140225001650 ID Practitioner - Certified Registered Nurse Anesthetist (Crna) 0547490260 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)

190 E Bannock St
Boise, ID 83712-6241
Phone (208) 381-2222

Hospital & facility affiliations

  • St Luke'S Regional Medical Center Hospital, Boise, ID, CCN 130006

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
RNA886AIDMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Anesthesia Associates of Boise, P.a. CurrentSince Jan 9, 2024 Accepting new patients
Boise Anesthesia, P a Anesthesiology CurrentSince Jan 4, 2014 Accepting new patients
Boise Anesthesia, PA Anesthesiology Past Accepting new patients

Locations

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

1055 N Curtis Rd
Boise, ID 83706
Phone (208) 367-2152

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

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

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

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.

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": "1376438400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1453334400000",
    "number": "1386077220",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4268",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972084268",
            "telephone_number": "503-372-2740"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1055 N CURTIS RD",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837061309",
            "telephone_number": "208-367-6416"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REID",
        "first_name": "JESSICA",
        "middle_name": "L",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-08-14",
        "last_updated": "2016-01-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "ID",
            "license": "RNA886A",
            "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 21, 2016; 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.