Individual provider Active NPI

Bradley Scott Dalling, CRNA

  • Certified Registered Nurse Anesthetist
  • Elkhart, IN
National Provider Identifier
1619396249
Registry record updated May 23, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
101872 Issued in ID
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

Updated by the provider on May 23, 2019

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 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. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
101872IDMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Anesthesiology Consultants of Treasure Valley PLLC CurrentSince Jan 29, 2024 Accepting new patients
Anesthesia Associates of Boise, P.a. CurrentSince Aug 22, 2023 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.

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.

Verify at the official NPI Registry.