| Mr Justin R Gibb, CRNA | |
|
1828 S Millenium Way, Meridian, ID 83642-5036 | |
| (208) 381-0262 | |
| Not Available |
| Full Name | Mr Justin R Gibb |
|---|---|
| Gender | Male |
| Speciality | Certified Registered Nurse Anesthetist (crna) |
| Experience | 17 Years |
| Location | 1828 S Millenium Way, Meridian, Idaho |
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1023263894 | NPI | - | NPPES |
| 2701125 | Other | REGENCE | |
| P00725584 | Other | RAILROAD MEDICARE | |
| 1023263894 | Medicaid | ID | |
| 500603268 | Medicaid | OR |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 367500000X | Nurse Anesthetist, Certified Registered | RNA728 (Idaho) | Secondary |
| 367500000X | Nurse Anesthetist, Certified Registered | 200860041CRNA (Oregon) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Saint Alphonsus Medical Center - Ontario, Inc | Ontario, OR | Hospital |
| Saint Alphonsus Medical Center - Nampa | Nampa, ID | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Treasure Valley Anesthesia Pc | 2365414497 | 5 |
| Treasure Valley Anesthesia Pc | 2365414497 | 5 |
| Anesthesiology Consultants Of Treasure Valley Pllc | 4981661196 | 26 |
| St Alphonsus Professional Medical Services Llc | 7214849751 | 106 |
| Entity Name | Treasure Valley Anesthesia Pc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1215992003 PECOS PAC ID: 2365414497 Enrollment ID: O20040810000538 |
| Entity Name | Saint Alphonsus Medical Center Baker City Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1881726206 PECOS PAC ID: 4981732518 Enrollment ID: O20100618000209 |
| Mailing Address | Practice Location Address |
|---|---|
| Mr Justin R Gibb, CRNA Po Box 2263, Idaho Falls, ID 83403-2263 Ph: (208) 525-2090 | Mr Justin R Gibb, CRNA 1828 S Millenium Way, Meridian, ID 83642-5036 Ph: (208) 381-0262 |
Heather J Nasker, CRNA, MSN Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 3235 N Towerbridge Way, #100, Meridian, ID 83646 Phone: 208-412-8177 | |
Charles Stiff, CRNA Nurse Anesthetist - CR Medicare: Not Enrolled in Medicare Practice Location: 520 S Eagle Rd, Suite 3104, Meridian, ID 83642 Phone: 208-373-1200 | |
Clayton Sanders, CRNA Nurse Anesthetist - CR Medicare: Medicare Enrolled Practice Location: 520 S Eagle Rd, Suite 3104, Meridian, ID 83642 Phone: 208-373-1200 | |
Mr. Brent V Bowles, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 1828 S Millenium Way Ste 100, Meridian, ID 83642 Phone: 208-445-2456 | |
Marguerite Overton, CRNA Nurse Anesthetist - CR Medicare: Medicare Enrolled Practice Location: 520 S Eagle Rd, Suite 3104, Meridian, ID 83642 Phone: 208-373-1200 | |
Steven Berg, CRNA Nurse Anesthetist - CR Medicare: Medicare Enrolled Practice Location: 520 S Eagle Rd, Suite 3104, Meridian, ID 83642 Phone: 208-373-1200 |