JACOB L. LUFKIN (NPI# 1457741167) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1457741167 |
| Entity Type | Individual |
| Full Name | JACOB L. LUFKIN |
| Credential | C.R.N.A. |
| Practice Address |
164 S 5th St Montpelier ID 83254-1597 |
| Mailing Address |
123 Valley View Dr Montpelier ID 83254-1529 |
| Practice Telephone | 2088471630 |
| Mailing Telephone | 2086045009 |
| Enumeration Date | 2015-02-02 |
| Last Update Date | 2020-03-23 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 163W00000X | Registered Nurse | 28219682A | IN | Nursing Service Providers |
| Y | 367500000X | Nurse Anesthetist, Certified Registered | 57248 | ID | Physician Assistants & Advanced Practice Nursing Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 5734 Coventry Ln, Fort Wayne, IN 468047141 | 2604367875 | 2604329812 |
| Street Address |
164 S 5TH ST |
| City | MONTPELIER |
| State | ID |
| Zip Code | 83254-1597 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336125533 | Bear Lake County Memorial Hospital | General Acute Care Hospital | 164 S 5th St, Montpelier, ID 83254-1557 | 2005-12-20 |
| 1821482365 | William Crane | Physical Therapist | 164 S 5th St, Montpelier, ID 83254-1557 | 2015-03-23 |
| 1184065849 | Joseph Dayton | Physician Assistant | 164 S 5th St, Montpelier, ID 83254-1557 | 2013-07-10 |
| 1235470196 | Bonnie Colleen Caywood | Dietitian, Registered | 164 S 5th St, Montpelier, ID 83254-1557 | 2013-03-01 |
| 1376871749 | Bear Lake County Memorial Hospital | Orthopaedic Surgery | 164 S 5th St, Montpelier, ID 83254-1557 | 2009-11-24 |
| 1639399793 | Bear Lake Memorial Hospital | General Acute Care Hospital | 164 S 5th St, Montpelier, ID 83254-1557 | 2007-04-30 |
| 1619195989 | Bear Lake County Memorial Hospital | General Acute Care Hospital | 164 S 5th St, Montpelier, ID 83254-1557 | 2007-04-23 |
| 1386767465 | Richard Bergman | Social Worker | 164 S 5th St, Montpelier, ID 83254-1557 | 2007-04-06 |
| 1699814574 | Bear Lake County Memorial Hospital | Pharmacy | 164 S 5th St, Montpelier, ID 83254-1557 | 2007-02-06 |
| 1669521084 | Bear Lake County Memorial Hospital | Home Health | 164 S 5th St, Montpelier, ID 83254-1557 | 2007-01-09 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366597866 | Joseph F Decker Professional Corp | Surgery | 164 S 5th, Montpelier, ID 83254 | 2007-01-24 |
| 1447311139 | Bear Lake County | Ambulance | 385 Cemetary Road, Montpelier, ID 83254 | 2006-12-13 |
| 1073685343 | Steven D Hammond | Dentist | 455 Washington St, Montpelier, ID 83254 | 2006-11-14 |
| 1982610549 | Dorian S Grunig | Nurse Anesthetist, Certified Registered | 164 South 5th, Montpelier, ID 83254 | 2006-08-01 |
| 1104840412 | Harold A Olson | Pharmacist | 765 Washington St., Montpelier, ID 83254 | 2006-07-27 |
| 1033603345 | Sydnie M Hobbs | Nurse Practitioner | 152 S 4th St, Montpelier, ID 83254 | 2018-06-20 |
| 1265505705 | Robert D Degnan | Obstetrics & Gynecology | 742 Washington St, Montpelier, ID 83254 | 2006-11-15 |
| 1952491714 | Gary Scott Griffin | Nurse Anesthetist, Certified Registered | 164 South 5th, Montpelier, ID 83254 | 2006-10-13 |
| 1013027952 | Matthew Brinton Stevens | Chiropractor | 710 N 4th St, Montpelier, ID 83254-1050 | 2006-08-30 |
| 1265542435 | Reset P.a. | Chiropractor | 710 N 4th St, Montpelier, ID 83254-1050 | 2006-08-30 |
| Find all providers in zip 83254 | ||||
| Taxonomy Code | 367500000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Anesthetist, Certified Registered |
| (1) A licensed registered nurse with advanced specialty education in anesthesia who, in collaboration with appropriate health care professionals, provides preoperative, intraoperative, and postoperative care to patients and assists in management and resuscitation of critical patients in intensive care, coronary care, and emergency situations. Nurse anesthetists are certified following successful completion of credentials and state licensure review and a national examination directed by the Council on Certification of Nurse Anesthetists. (2) A registered nurse who is qualified by special training to administer anesthesia in collaboration with a physician or dentist and who can assist in the care of patients who are in critical condition. |
| Notes: Sources: (1) Council on Certification of Nurse Anesthetists, Park Ridge, IL, and Rhea, Ott, and Shafritz, The Facts On File Dictionary of Health Care Management, New York: Facts On File Publications, 1988. (2) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, The Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, Illinois: 1994, p. 548. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982610549 | Dorian S Grunig | Nurse Anesthetist, Certified Registered | 164 South 5th, Montpelier, ID 83254 | 2006-08-01 |
| 1952491714 | Gary Scott Griffin | Nurse Anesthetist, Certified Registered | 164 South 5th, Montpelier, ID 83254 | 2006-10-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134764293 | Steven J Berg Anesthesia Pllc | Nurse Anesthetist, Certified Registered | 360 E Mallard Dr Ste 125, Boise, ID 83706-3941 | 2019-11-13 |
| 1013482207 | Griffin Anesthesia, LLC | Nurse Anesthetist, Certified Registered | 1157 Call Pl, Pocatello, ID 83201-4008 | 2018-10-04 |
| 1134630320 | Highline Anesthesia LLC | Nurse Anesthetist, Certified Registered | 1225 Old Oregon Rd, Soda Springs, ID 83276-5608 | 2017-10-16 |
| 1598208795 | Ryan Steed | Nurse Anesthetist, Certified Registered | 4248 E Tahiti St, Meridian, ID 83646-6341 | 2016-11-21 |
| 1689039844 | John Meyers | Nurse Anesthetist, Certified Registered | 1080 Terra Ave, Twin Falls, ID 83301-4712 | 2015-12-15 |
| 1972976637 | Richardson Enterprises, Inc. | Nurse Anesthetist, Certified Registered | 319 115th St, Orofino, ID 83544-9375 | 2015-11-03 |
| 1467863829 | Grant Gundersen | Nurse Anesthetist, Certified Registered | 646 W 300 S, Blackfoot, ID 83221-6334 | 2014-05-19 |
| 1871918318 | West Idaho Anesthesia, LLP | Nurse Anesthetist, Certified Registered | 3115 Medical Dr, Caldwell, ID 83605-6972 | 2014-02-20 |
| 1871925057 | Dewey Michael Driscoll | Nurse Anesthetist, Certified Registered | 333 North 18th, Bldg A, Pocatello, ID 83201 | 2013-07-30 |
| 1225473069 | Brinton Anesthesia Group Pllc | Nurse Anesthetist, Certified Registered | 1828 S Millenium Way, Meridian, ID 83642-5036 | 2013-05-07 |
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| City | MONTPELIER |
| Zip Code | 83254 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.