Active NPI
Robert K Smith, CRNA
- Certified Registered Nurse Anesthetist
- Moscow, ID
National Provider Identifier
1861486565
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Certified Registered Nurse Anesthetist
- License
- RNA-357
- Practice address
- 2300 W a St
Moscow, ID 83843-4038 - Phone
- (208) 883-1500
- Fax
- (208) 882-7701
- NPI assigned
- Sep 8, 2005
- 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 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Anesthesiology Physician | 207L00000X | N24684 | ID | |
| Certified Registered Nurse Anesthetist | 367500000X | RNA-357 | ID | Primary |
| Certified Registered Nurse Anesthetist | 367500000X | AP30004499 | WA |
Addresses
Primary practice location
2300 W a St
Moscow, ID 83843-4038
Mailing address
PO Box 1829
Coeur D Alene, ID 83816-1829
Phone (208) 667-9334
Other identifiers 5
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 001667900 | Medicaid | ID | |
| N24684 | Other | ID | IDAHO LICENSE |
| A3516 | Other | ID | BC ID |
| P00137199 | Other | RAILROAD MEDICARE | |
| 9640327 | Medicaid | WA |
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)
- Enrolled
- Credentials
- Certified Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| N24684 | ID | MD | Anesthesiology Physician |
| RNA-357 | ID | MD | Certified Registered Nurse Anesthetist |
| AP30004499 | WA | MD | Certified Registered Nurse Anesthetist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1126137600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1278979200000",
"number": "1861486565",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1829",
"city": "COEUR D ALENE",
"state": "ID",
"postal_code": "838161829",
"telephone_number": "208-667-9334",
"fax_number": "208-664-2341"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2300 W A ST",
"city": "MOSCOW",
"state": "ID",
"postal_code": "838434038",
"telephone_number": "208-883-1500",
"fax_number": "208-882-7701"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SMITH",
"first_name": "ROBERT",
"middle_name": "K",
"credential": "CRNA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-09-08",
"last_updated": "2010-07-13",
"status": "A"
},
"taxonomies": [
{
"code": "207L00000X",
"taxonomy_group": "",
"desc": "Anesthesiology",
"state": "ID",
"license": "N24684",
"primary": false
},
{
"code": "367500000X",
"taxonomy_group": "",
"desc": "Nurse Anesthetist, Certified Registered",
"state": "ID",
"license": "RNA-357",
"primary": true
},
{
"code": "367500000X",
"taxonomy_group": "",
"desc": "Nurse Anesthetist, Certified Registered",
"state": "WA",
"license": "AP30004499",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "001667900",
"state": "ID"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "IDAHO LICENSE",
"identifier": "N24684",
"state": "ID"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BC ID",
"identifier": "A3516",
"state": "ID"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "P00137199",
"state": null
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "9640327",
"state": "WA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Moscow, ID
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.