Charles B Gladwell, CRNA

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

TEMPORARY Issued in ID

Practice address

111 W State St
Boise, ID 83702-6127

Phone

(208) 336-0895

Fax

(208) 338-1796

NPI assigned

Sep 26, 2008

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in UT

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Registered Nurse

State licenses

Practice roles

Locations

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.

• Mt Ogden Anesthesia Group LLC

  • Certified Registered Nurse Anesthetist
  • Ogden, UT
  • NPI 1770999807

  Nurse Anesthetist, Certified Registered

  Medicare reassignment NPD
• Anesthesia Associates of Boise, P.a.

  • Specialist
  • Boise, ID
  • NPI 1033147467
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1222387200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1222387200000",
    "number": "1689824633",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 W STATE ST",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837026127",
            "telephone_number": "208-336-0895",
            "fax_number": "208-338-1796"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 W STATE ST",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837026127",
            "telephone_number": "208-336-0895",
            "fax_number": "208-338-1796"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GLADWELL",
        "first_name": "CHARLES",
        "middle_name": "B",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-09-26",
        "last_updated": "2008-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "ID",
            "license": "TEMPORARY",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Giannantonio Giuliani, M.D.
• Zyrah Giustra, DC
• Elizabeth Givens, RN
• Morgan Givens
• Nichole Louise Givens, RRT, RPSGT
• Joshua Gladwin
• Glass Half Full
• Justin A Glass, M.D.
• Anna Glatt
• Steven Glazier, PT

• Certified Registered Nurse Anesthetist in Boise, ID
• Providers in Boise, ID by specialty
• Certified Registered Nurse Anesthetist in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2008; 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.