Jon F Champlin, CRNA

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

RNA328A Issued in ID

Practice address

1945 E 17TH St
Idaho Falls, ID 83404-6429

Phone

(208) 529-1945

NPI assigned

Nov 2, 2006

Last updated

Dec 21, 2007By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Registered Nurse

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Medical Imaging Associates of Idaho Falls, Inc

  • Diagnostic Radiology Physician
  • Pocatello, ID
  • NPI 1740225531
  NPD (past)
• Teton Valley Health Care Inc

  dba Teton Valley Health Care

  • Critical Access Hospital
  • Driggs, ID
  • NPI 1477809622
  NPD (past)

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

{
    "created_epoch": "1162425600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1198195200000",
    "number": "1386722429",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 52180",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834052180",
            "telephone_number": "208-523-4906",
            "fax_number": "208-523-2025"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1945 E 17TH ST",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834046429",
            "telephone_number": "208-529-1945"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHAMPLIN",
        "first_name": "JON",
        "middle_name": "F",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-02",
        "last_updated": "2007-12-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "ID",
            "license": "RNA328A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P0015576",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Maria Teresa Cervantes-Fullmer, FNP
• Chamberlain General Surgery PA
• David J Chamberlain, D.O.
• John D Chambers Jr., M.D.
• Mark Aaron Chambers, DDS
• Kenna Chancey, LCSW
• Brynlee Chandler, COTA/L
• Channing Physical Therapy & Associates LLC (Channing Physical Therapy)
• Channing Physical Therapy PC
• Channing Way Dental Care

• Certified Registered Nurse Anesthetist in Idaho Falls, ID
• Providers in Idaho Falls, ID by specialty
• Certified Registered Nurse Anesthetist in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 21, 2007; 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.