Individual provider Active NPI

Timothy A Powell

  • Certified Registered Nurse Anesthetist
  • Boise, ID
National Provider Identifier
1972617363
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
RNA-579 Issued in ID
Practice address
111 W State St
Boise, ID 83702-6127
Phone
(208) 336-0895
NPI assigned
Aug 19, 2006
Last updated
Jul 9, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

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 RNA-579 ID Primary

Addresses

Primary practice location

111 W State St
Boise, ID 83702-6127

Mailing address

111 W State St
Boise, ID 83702-6127

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ID, OR2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20040525000820 ID Practitioner - Certified Registered Nurse Anesthetist (Crna) 2668463506 Reassigns benefits to 3 organizations
I20240627000043 OR Practitioner - Certified Registered Nurse Anesthetist (Crna) 2668463506 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2003
Medicare assignment
May accept Medicare assignment
Group practices
West Idaho Anesthesia, LLPGroup PAC ID 9133343031, 15 clinicians

Practice addresses (Care Compare)

251 SW 19TH St
Ontario, OR 97914-1972
Phone (541) 889-3198

3115 Medical Dr
Caldwell, ID 83605-6972
Phone (208) 453-8668

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RNA-579IDMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Intermountain Ambulatory Anesthesia PLLC Nurse Anesthetist, Certified Registered CurrentSince Feb 1, 2022 Accepting new patients
Idaho Anesthesia Partners LLC Nurse Anesthetist, Certified Registered Current Accepting new patients
Anesthesia Consulting Partners Idaho, PC Nurse Anesthetist, Certified Registered CurrentSince Nov 13, 2023 Accepting new patients
Cardiac and Arrhythmia Center of Idaho PLLC CurrentSince Jun 1, 2022 Accepting new patients
West Idaho Anesthesia, LLP Nurse Anesthetist, Certified Registered CurrentSince Oct 1, 2020 Accepting new patients
Anesthesia Associates of Boise, P.a. PastSince Jun 17, 1997 Accepting new patients
Sheridan Healthcare of Washington, PC Nurse Anesthetist, Certified Registered Past Accepting new patients
Sheridan Healthcare of Washington, PC Nurse Anesthetist, Certified Registered PastSince Sep 25, 2019 Accepting new patients
Everest ASC Past Accepting new patients
Tahoma Anesthesiology Consultants PS Past Accepting new patients
Narrows Anesthesia Services PLLC Nurse Anesthetist, Certified Registered Past Accepting new patients

Locations

600 N Robbins Rd
Ste 401
Boise, ID 83702
Phone (208) 489-4279

811 N Liberty St
Boise, ID 83704
Phone (208) 323-4522

1717 Arlington Ave
Caldwell, ID 83605
Phone (208) 455-3719

3115 Medical Dr
Caldwell, ID 83605
Phone (208) 453-8668

1828 S Millenium Way
Ste 100
Meridian, ID 83642
Phone (208) 381-0262

2960 E St Lukes St
Ste 100
Meridian, ID 83642
Phone (208) 378-4264

3071 E Franklin Rd
Ste 101
Meridian, ID 83642
Phone (208) 288-1400

875 S Vanguard Way
Ste 300
Meridian, ID 83642
Phone (208) 960-0650

251 SW 19th St
Ontario, OR 97914
Phone (541) 889-3106

Organizations & group practices 11

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.

NPI Registry JSON

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

{
    "created_epoch": "1155945600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1972617363",
    "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"
        },
        {
            "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"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POWELL",
        "first_name": "TIMOTHY",
        "middle_name": "A",
        "name_prefix": "Mr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-19",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "ID",
            "license": "RNA-579",
            "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 Jul 9, 2007; 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.