Individual provider Active NPI

John R Kerfoot, CRNA

  • Certified Registered Nurse Anesthetist
  • Ontario, OR
National Provider Identifier
1598810863
Registry record updated Mar 2, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
RNA379 Issued in ID
Practice address
351 SW 9TH St
Ontario, OR 97914-2639
Phone
(541) 881-7146
NPI assigned
Jan 24, 2007
Last updated
Mar 2, 2010By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 2, 2010

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 RNA379 ID Primary

Addresses

Primary practice location

351 SW 9TH St
Ontario, OR 97914-2639

Mailing address

PO Box 2936
Idaho Falls, ID 83403-2936
Phone (208) 552-8773

Other identifiers 2

IdentifierTypeStateIssuer
804141200MedicaidID
P00709265OtherRAILROAD MEDCIARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ID, OR2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20070725000765 ID Practitioner - Certified Registered Nurse Anesthetist (Crna) 5597866137 Reassigns benefits to 1 organization
I20090422000175 OR Practitioner - Certified Registered Nurse Anesthetist (Crna) 5597866137 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
RNA379IDMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
West Idaho Anesthesia, LLP Nurse Anesthetist, Certified Registered CurrentSince Mar 31, 2014 Accepting new patients

Locations

3115 Medical Dr
Caldwell, ID 83605
Phone (208) 453-8668

251 SW 19th St
Ontario, OR 97914
Phone (541) 889-3106

Organizations & group practices 1

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": "1169596800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1267488000000",
    "number": "1598810863",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2936",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834032936",
            "telephone_number": "208-552-8773",
            "fax_number": "208-523-2025"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "351 SW 9TH ST",
            "city": "ONTARIO",
            "state": "OR",
            "postal_code": "979142639",
            "telephone_number": "541-881-7146"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KERFOOT",
        "first_name": "JOHN",
        "middle_name": "R",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-24",
        "last_updated": "2010-03-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "ID",
            "license": "RNA379",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "804141200",
            "state": "ID"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDCIARE",
            "identifier": "P00709265",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ontario, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 2, 2010; 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.