Active NPI
Bradley Scott Dalling, CRNA
- Certified Registered Nurse Anesthetist
- Elkhart, IN
National Provider Identifier
1619396249
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Certified Registered Nurse Anesthetist
- License
- 101872
- Practice address
- 600 East Blvd
Elkhart, IN 46514-2483 - Phone
- (801) 822-2011
- NPI assigned
- Apr 10, 2014
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Certified Registered Nurse Anesthetist | 367500000X | 101872 | ID | Primary |
Addresses
Primary practice location
600 East Blvd
Elkhart, IN 46514-2483
Mailing address
1828 S Millenium Way
Meridian, ID 83642-5036
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- HHS exclusion list flag
- Flagged The directory lists this NPI on an HHS exclusion list.
- Credentials
- Certified Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 101872 | ID | MD | Certified Registered Nurse Anesthetist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Anesthesiology Consultants of Treasure Valley PLLC | Current | Accepting new patients | |
| Anesthesia Associates of Boise, P.a. | Current | Accepting new patients |
Locations
338 E Bannock St
Boise, ID 83712
Phone (208) 336-0895
2537 W State St
Ste 200
Boise, ID 83702
Phone (208) 336-0895
8800 W Emerald St
Boise, ID 83704
Phone (208) 373-5000
1000 State St
McCall, ID 83638
Phone (208) 634-2221
Organizations & group practices 2
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.
-
- Specialist
- Boise, ID
- NPI 1033147467
-
- Anesthesiology Physician
- Boise, ID
- NPI 1124066063
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1397088000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1558569600000",
"number": "1619396249",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1828 S MILLENIUM WAY",
"city": "MERIDIAN",
"state": "ID",
"postal_code": "836425036"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "600 EAST BLVD",
"city": "ELKHART",
"state": "IN",
"postal_code": "465142483",
"telephone_number": "801-822-2011"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DALLING",
"first_name": "BRADLEY",
"middle_name": "SCOTT",
"credential": "CRNA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2014-04-10",
"last_updated": "2019-05-23",
"status": "A"
},
"taxonomies": [
{
"code": "367500000X",
"taxonomy_group": "",
"desc": "Nurse Anesthetist, Certified Registered",
"state": "ID",
"license": "101872",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Elkhart, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 23, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.