Individual provider Active NPI

David L Merrill, CRNA

  • Certified Registered Nurse Anesthetist
  • Boise, ID
National Provider Identifier
1801069190
Registry record updated Apr 8, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
RNA715 Issued in ID
Practice address
111 W State St
Boise, ID 83702-6127
Phone
(208) 336-0895
Fax
(208) 338-1796
NPI assigned
Apr 8, 2008
Last updated
Apr 8, 2008By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 8, 2008

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 RNA715 ID Primary

Addresses

Primary practice location

111 W State St
Boise, ID 83702-6127

Mailing address

111 W State St
Boise, ID 83702-6127
Phone (208) 336-0895

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ID

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080429000264 ID Practitioner - Certified Registered Nurse Anesthetist (Crna) 8426136672 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Anesthesia Associates of Boise, P.a.Group PAC ID 2668385287, 183 clinicians

Practice addresses (Care Compare)

1000 State St
McCall, ID 83638-3704
Phone (208) 634-2221

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
RNA715IDMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Anesthesia Associates of Boise, P.a. CurrentSince Mar 31, 2008 Accepting new patients

Locations

2537 W State St
Ste 200
Boise, ID 83702
Phone (208) 336-0895

338 E Bannock St
Boise, ID 83712
Phone (208) 336-0895

1000 State St
McCall, ID 83638
Phone (208) 634-2221

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1207612800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1207612800000",
    "number": "1801069190",
    "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": "MERRILL",
        "first_name": "DAVID",
        "middle_name": "L",
        "name_prefix": "Mr.",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-04-08",
        "last_updated": "2008-04-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "ID",
            "license": "RNA715",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boise, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.