Steven Berg, CRNA
Individual provider Active NPI Certified Registered Nurse Anesthetist · Meridian, ID
NPI 1386662633 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1386662633
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Certified Registered Nurse Anesthetist 367500000X
- License
- N-18880 (ID)
- Practice address
- 520 S Eagle Rd
Suite 3104
Meridian, ID 83642-6308 - Phone
- (208) 373-1200
- NPI assigned
- Jul 17, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in ID
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20040721000580 | ID | Practitioner - Certified Registered Nurse Anesthetist (Crna) | 0648253740 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Certified Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| N-18880 | ID | MD | Certified Registered Nurse Anesthetist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Steven J Berg Anesthesia PLLC | Nurse Anesthetist, Certified Registered | Current |
Accepting new patients |
Locations
360 E Mallard Dr
Ste 125
Boise, ID 83706
Phone (208) 330-8700
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Certified Registered Nurse Anesthetist | 367500000X | N-18880 | ID | Yes |
Addresses
Primary practice location
520 S Eagle Rd
Suite 3104
Meridian, ID 83642-6308
Mailing address
PO Box 2203
Idaho Falls, ID 83403-2203
Phone (208) 525-2090
Other providers in Meridian, ID
- Kari Kristin Benton
- Sara Berberich
- Allyson Jenifer Berg
- Daranee Berg
- Leila Marie Berg
- Andrew Murray Bergloff II
- John Andrew Bergloff
- William G Bergquist
- Charity Kristin Berrier
- Althea Berry
All providers in Meridian, ID · Certified Registered Nurse Anesthetist in Idaho
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.