NPIMap

Individual provider Active NPI

David Allen Kallberg, CRNA

  • Certified Registered Nurse Anesthetist
  • Salem, OR
National Provider Identifier
1578890596
Registry record updated Jun 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
201260003CRNA Issued in OR
Practice address
3099 River Rd S # 100
Salem, OR 97302-9754
Phone
(503) 361-3094
NPI assigned
Nov 12, 2009
Last updated
Jun 5, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 5, 2024

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 201260003CRNA OR Primary

Addresses

Primary practice location

3099 River Rd S # 100
Salem, OR 97302-9754

Mailing address

1010 SE 47TH Ave
Hillsboro, OR 97123-7514
Phone (208) 577-7045

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120508000447 OR Practitioner - Certified Registered Nurse Anesthetist (Crna) 0941462964 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Oregon Health Sciences University School of Medicine, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Noble Dreams Anesthesia LLCGroup PAC ID 5698036945, 5 clinicians
Tuality Anesthesia Services LLCGroup PAC ID 3274712864, 30 clinicians
Hospitalist Medicine Physicians of Washington - TCSGroup PAC ID 6800240102, 197 clinicians

Practice addresses (Care Compare)

3099 River Rd S
Suite 100
Salem, OR 97302-9754
Phone (503) 758-0892

335 SE 8TH Ave
Hillsboro, OR 97123-4246
Phone (503) 681-1270

9205 SW Barnes Rd
Portland, OR 97225-6603
Phone (503) 216-1234

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Kaiser Foundation Health Plan of the Northwest Nurse Anesthetist, Certified Registered Current Accepting new patients
Anesthetic Solutions, Inc Nurse Anesthetist, Certified Registered CurrentSince Mar 1, 2026 Accepting new patients
Tuality Anesthesia Services, LLC CurrentSince Jul 1, 2024 Accepting new patients
Hospitalist Medicine Physicians of Washington - TCS Nurse Anesthetist, Certified Registered CurrentSince Dec 27, 2023 Accepting new patients
Noble Dreams Anesthesia LLC Nurse Anesthetist, Certified Registered CurrentSince Nov 22, 2022 Accepting new patients
Kaiser Foundation Health Plan of the Northwest CurrentSince Feb 27, 2012 Accepting new patients

Locations

10100 SE Sunnyside Rd
Clackamas, OR 97015
Phone (503) 571-2946

10180 SE Sunnyside Rd
Clackamas, OR 97015
Phone (503) 571-2880

335 SE 8th Ave
Hillsboro, OR 97123
Phone (503) 681-1111

7201 N Interstate Ave
Portland, OR 97217
Phone (503) 240-4051

9205 SW Barnes Rd
Portland, OR 97225
Phone (503) 216-1234

2400 Lancaster Dr NE
Salem, OR 97305
Phone (503) 361-5400

3099 River Rd S
#100
Salem, OR 97302
Phone (503) 361-3094

3099 River Rd S
Ste 100
Salem, OR 97302
Phone (503) 361-3094

Organizations & group practices 6

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.

Hospital & facility affiliations 13

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1257984000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717545600000",
    "number": "1578890596",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1010 SE 47TH AVE",
            "city": "HILLSBORO",
            "state": "OR",
            "postal_code": "971237514",
            "telephone_number": "208-577-7045"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3099 RIVER RD S # 100",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973029754",
            "telephone_number": "503-361-3094"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KALLBERG",
        "first_name": "DAVID",
        "middle_name": "ALLEN",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-11-12",
        "last_updated": "2024-06-05",
        "certification_date": "2024-06-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "OR",
            "license": "201260003CRNA",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Salem, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 2024; 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.