Dale T Knievel, CRNA

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

RNA-33 Issued in ID

Practice address

1950 E Clark St
Suite G
Pocatello, ID 83201-3314

Phone

(208) 232-7760

Fax

(208) 232-1950

NPI assigned

May 11, 2006

Last updated

Oct 26, 2011By 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 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1147305600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1319587200000",
    "number": "1568412278",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4107",
            "city": "POCATELLO",
            "state": "ID",
            "postal_code": "832054107",
            "telephone_number": "208-232-7760",
            "fax_number": "208-232-1950"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1950 E CLARK ST",
            "address_2": "SUITE G",
            "city": "POCATELLO",
            "state": "ID",
            "postal_code": "832013314",
            "telephone_number": "208-232-7760",
            "fax_number": "208-232-1950"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KNIEVEL",
        "first_name": "DALE",
        "middle_name": "T",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-11",
        "last_updated": "2011-10-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "ID",
            "license": "RNA-33",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "ID",
            "license": "N10107",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004373000",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Steven R Klitgaard, PT
• Daniel M Knapp, LCSW
• Derek Curt Knapp, DPM
• Kenneth Michael Knapp, CRNA
• Tonja Knapp, RN
• Ann Knighton, RN
• Jason Knighton, NP-C
• Philip James Knox, M.D.
• Sarah Knudson, MS, CCC-SLP
• Winnie Sao Ting Ko

• Certified Registered Nurse Anesthetist in Pocatello, ID
• Providers in Pocatello, 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 Oct 26, 2011; 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.