Active NPI
Kimberly Rose Balangue, CRNA
- Certified Registered Nurse Anesthetist
- Boise, ID
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Certified Registered Nurse Anesthetist
- License
- 55260
- Practice address
- 1055 N Curtis Rd
Boise, ID 83706-1309 - Phone
- (208) 367-5170
- Fax
- (208) 367-5180
- NPI assigned
- Feb 20, 2007
- Last updated
- Sep 29, 2023
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Certified Registered Nurse Anesthetist | 367500000X | ARNP9254419 | FL | |
| Certified Registered Nurse Anesthetist | 367500000X | 55260 | ID | Primary |
Addresses
Primary practice location
1055 N Curtis Rd
Boise, ID 83706-1309
Mailing address
PO Box 7411114
Chicago, IL 60674-1114
Phone (208) 367-5170
Other practice location 1
2173 A Centerville Place
Tallahassee, FL 32308
Phone (800) 437-2672
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in FL, ID
Enrollment records 2
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Certified Registered Nurse
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| St Alphonsus Professional Medical Services LLC | Current | Accepting new patients | |
| St Alphonsus Professional Medical Services LLC | Anesthesiology | Current | Accepting new patients |
| Greater Florida Anesthesiologists, LLC | Anesthesiology | Current | Accepting new patients |
| Anesthesiology Associates of Tallahassee Inc | Anesthesiology | Past | Accepting new patients |
| Anesthesiology Associates of Tallahassee Inc | Anesthesiology | Past | Accepting new patients |
Locations
1055 N Curtis Rd
Boise, ID 83706
Phone (208) 367-2152
2855 E Magic View Dr
Meridian, ID 83642
Phone (208) 639-4900
1512 12th Ave Rd
Nampa, ID 83686
Phone (208) 463-5000
4300 E Flamingo Ave
Nampa, ID 83687
Phone (208) 367-6416
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.
-
dba SAMG Anesthesia
- Anesthesiology Physician
- Boise, ID
- NPI 1386677524
-
- Anesthesiology Physician
- St Petersburg, FL
- NPI 1942519657
-
dba St Alphonsus Trauma Physician Services
- Trauma Surgery Physician
- Boise, ID
- NPI 1336166883
-
- Anesthesiology Physician
- Safety Harbor, FL
- NPI 1528630795
-
- Anesthesiology Physician
- Tallahassee, FL
- NPI 1831171990
-
- Anesthesiology Physician
- Tallahassee, FL
- NPI 1922772037
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1171929600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1695945600000",
"number": "1598800526",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 7411114",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606741114",
"telephone_number": "208-367-5170",
"fax_number": "208-367-5180"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1055 N CURTIS RD",
"city": "BOISE",
"state": "ID",
"postal_code": "837061309",
"telephone_number": "208-367-5170",
"fax_number": "208-367-5180"
}
],
"practiceLocations": [
{
"address_1": "2173 A Centerville Place",
"address_purpose": "LOCATION",
"city": "Tallahassee",
"state": "FL",
"postal_code": "32308",
"country_code": "US",
"telephone_number": "800-437-2672",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "BALANGUE",
"first_name": "KIMBERLY",
"middle_name": "ROSE",
"credential": "CRNA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-02-20",
"last_updated": "2023-09-29",
"certification_date": "2023-09-29",
"status": "A"
},
"taxonomies": [
{
"code": "367500000X",
"taxonomy_group": "",
"desc": "Nurse Anesthetist, Certified Registered",
"state": "FL",
"license": "ARNP9254419",
"primary": false
},
{
"code": "367500000X",
"taxonomy_group": "",
"desc": "Nurse Anesthetist, Certified Registered",
"state": "ID",
"license": "55260",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Boise, ID
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.