Kimberly Rose Balangue, CRNA

Key facts

NPI

1598800526

Entity type

Individual (NPI type 1)

Primary specialty

Certified Registered Nurse Anesthetist 367500000X

License

55260 (ID)

Practice address

1055 N Curtis Rd
Boise, ID 83706-1309

Phone

(208) 367-5170

Fax

(208) 367-5180

NPI assigned

Feb 20, 2007

Sex

Female

Sole proprietor

No

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 and National Provider Directory roles.

• St Alphonsus Professional Medical Services LLC Anesthesiology Physician · Boise, ID · NPI 1386677524
  Medicare reassignment NPD ANESTHESIOLOGY · ID
• Greater Florida Anesthesiologists, LLC Anesthesiology Physician · St Petersburg, FL · NPI 1942519657
  Medicare reassignment FL
• St Alphonsus Professional Medical Services LLC Trauma Surgery Physician · Boise, ID · NPI 1336166883
  NPD
• Greater Florida Anesthesiologists, LLC Anesthesiology Physician · Safety Harbor, FL · NPI 1528630795
  NPD ANESTHESIOLOGY
• Anesthesiology Associates of Tallahassee Inc Anesthesiology Physician · Tallahassee, FL · NPI 1831171990
  NPD (past) ANESTHESIOLOGY
• Anesthesiology Associates of Tallahassee Inc Anesthesiology Physician · Tallahassee, FL · NPI 1922772037
  NPD (past) ANESTHESIOLOGY

Medicare participation

Medicare fee-for-service enrollment

Enrolled (2 enrollments) in FL, ID

Medicare enrollment records

National Provider Directory

Medicare enrollment (NPD)

Yes

Credentials

Certified Registered Nurse

Practice roles

Locations

Specialties & licenses

Addresses

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Sep 29, 2023.

{
    "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": []
}

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All providers in Boise, ID · Certified Registered Nurse Anesthetist in Idaho