Wayde Russell Blumhardt, CRNA

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

D-074832 Issued in IA

Practice address

1825 Logan Ave
Waterloo, IA 50703

Phone

(319) 235-3886

Fax

(319) 233-1630

NPI assigned

May 18, 2006

Last updated

Dec 10, 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 4

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Merit-based Incentive Payment System (MIPS)

Final score

93.78 of 100Reported as apm

Quality

80.38

Promoting interoperability

100

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Registered Nurse

State licenses

Practice roles

Locations

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.

• Waverly Health Center

  dba Waverly Health Center Anesthesia

  • Certified Registered Nurse Anesthetist
  • Waverly, IA
  • NPI 1033125463

  Nurse Anesthetist, Certified Registered

  NPD
• Waverly Health Center

  dba Janesville Clinic

  • Rural Health Clinic/Center
  • Janesville, IA
  • NPI 1184094534
  NPD

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

{
    "created_epoch": "1147910400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1197244800000",
    "number": "1528011996",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2758",
            "city": "WATERLOO",
            "state": "IA",
            "postal_code": "507042758",
            "telephone_number": "319-235-5390",
            "fax_number": "319-233-1630"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1825 LOGAN AVE",
            "city": "WATERLOO",
            "state": "IA",
            "postal_code": "50703",
            "telephone_number": "319-235-3886",
            "fax_number": "319-233-1630"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLUMHARDT",
        "first_name": "WAYDE",
        "middle_name": "RUSSELL",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-18",
        "last_updated": "2007-12-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "IA",
            "license": "D-074832",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLMARK INS PLAN",
            "identifier": "55001",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "JOHN DEERE HEALTH INS",
            "identifier": "42141730780",
            "state": "IA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2062018",
            "state": "IA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3062018",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Michael J Blough, DC
• Rachel Sue Blough
• Kathryn Marie Boaldin, DPT
• Bryan Boardsen, MOT
• Ann Marie Bock, MSN,ARNP, FNP-C
• Zubair Hassan Bodla, M.D.
• Steven D Boeke, O.D.

• Certified Registered Nurse Anesthetist in Waterloo, IA
• Providers in Waterloo, IA by specialty
• Certified Registered Nurse Anesthetist in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• 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.