Individual provider Active NPI

Kimberly Rose Balangue, CRNA

  • Certified Registered Nurse Anesthetist
  • Boise, ID
National Provider Identifier
1598800526
Registry record updated Sep 29, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
55260 Issued in ID
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, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 29, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
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, ID2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20070615000622 FL Practitioner - Certified Registered Nurse Anesthetist (Crna) 9537268586 Reassigns benefits to 1 organization
I20170630001947 ID Practitioner - Certified Registered Nurse Anesthetist (Crna) 9537268586 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
St Alphonsus Professional Medical Services LLC CurrentSince Nov 1, 2023 Accepting new patients
St Alphonsus Professional Medical Services LLC Anesthesiology CurrentSince Nov 1, 2023 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.

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.

Verify at the official NPI Registry.