MR. BRUCE WILLIAM DEMKO (NPI# 1780651539) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1780651539 |
| Entity Type | Individual |
| Full Name | MR. BRUCE WILLIAM DEMKO |
| Credential | CRNA |
| Practice Address |
30544 Highway 200 Ponderay ID 83852-5005 |
| Mailing Address |
Po Box 591 Sagle ID 83860 |
| Practice Telephone | 2082558013 |
| Mailing Telephone | 2082653534 |
| Mailing Fax Number | 2082653534 |
| Enumeration Date | 2006-03-01 |
| Last Update Date | 2012-04-13 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 367500000X | Nurse Anesthetist, Certified Registered | RNA491A | ID | Physician Assistants & Advanced Practice Nursing Providers |
| N | 367500000X | Nurse Anesthetist, Certified Registered | N30209 | ID | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| ID | 805855300 | 05 |
| Street Address |
30544 HIGHWAY 200 |
| City | PONDERAY |
| State | ID |
| Zip Code | 83852-5005 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679110845 | Angela Alice Chapin | Massage Therapist | 30544 Highway 200, Ponderay, ID 83852-5005 | 2019-12-05 |
| 1851894018 | Jessica Hunt | Massage Therapist | 30544 Highway 200, Ponderay, ID 83852-5005 | 2018-03-14 |
| 1235649625 | Kauai In-home Therapy LLC | Clinic/Center | 30544 Highway 200, Ponderay, ID 83852-5005 | 2017-10-11 |
| 1932527389 | Stuart Gall Crna Inc | Nurse Anesthetist, Certified Registered | 30544 Highway 200, Suite 201, Ponderay, ID 83852-5005 | 2014-04-02 |
| 1669756813 | Nichole Suzanne Grimm | Nurse Practitioner | 30544 Highway 200, Ste 101, Ponderay, ID 83852-5005 | 2011-10-06 |
| 1073757464 | Michael R Dibenedetto Md Pllc | Surgery | 30544 Highway 200, Suite 102, Ponderay, ID 83852-5005 | 2009-04-29 |
| 1891969606 | Jonathan Donald Fisher | Podiatrist | 30544 Highway 200, Suite 102, Ponderay, ID 83852-5005 | 2008-04-14 |
| 1376713008 | Bruce Demko Crna Inc | Nurse Anesthetist, Certified Registered | 30544 Highway 200, Ponderay, ID 83852-5005 | 2008-03-10 |
| 1821276353 | Pend Oreille Surgery Center LLC | Clinic/Center | 30544 Highway 200, Suite 201, Ponderay, ID 83852-5005 | 2008-02-06 |
| 1679644397 | Michael Raymond Dibenedetto | Orthopaedic Surgery | 30544 Highway 200, Ste 102, Ponderay, ID 83852-5005 | 2006-11-13 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346606647 | Vern Stairs | Pharmacist | 476999 Us-95, Walmart Supercenter, Ponderay, ID 83852 | 2016-01-04 |
| 1083809727 | Michael R Dibenedetto Md Pllc | Orthopaedic Surgery | 30544 Hwy 200, Ste 102, Ponderay, ID 83852 | 2007-09-06 |
| 1811009988 | David Paul Cox | Dentist | 477542 Hwy 95 N, Ponderay, ID 83852 | 2006-08-31 |
| 1861774291 | Michael David Schicker | Orthopaedic Surgery | 30544 Highway 200 Ste 102, Ponderay, ID 83852 | 2011-09-12 |
| 1750410825 | Glacier Prosthetic Care, Inc. | Prosthetic/Orthotic Supplier | 205 Vermeer Dr, Suite C, Ponderay, ID 83852-1660 | 2007-03-05 |
| 1083949531 | Mario E Roxas | Naturopath | 476864 Highway 95, Suite #3, Ponderay, ID 83852-5000 | 2009-10-15 |
| 1942716246 | Darwin L Hurst | Family Medicine | 30544 Highway 200 Ste 101, Ponderay, ID 83852-5005 | 2017-12-21 |
| 1902036734 | Innovative Anesthesia | Nurse Anesthetist, Certified Registered | 30544 Highway 200 Ste 201, Pend Oreille Surgery Center, Ponderay, ID 83852-5005 | 2009-07-14 |
| 1255597811 | Travis Lee Taylor | Nurse Practitioner | 30544 Highway 200 Ste 102, Ponderay, ID 83852-5005 | 2008-08-04 |
| 1982741195 | Ryan Leisy | Chiropractor | 30544 Highway 200 Ste 330, Ponderay, ID 83852-5005 | 2007-01-30 |
| Find all providers in zip 83852 | ||||
| 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 |
|---|---|---|---|---|
| 1902036734 | Innovative Anesthesia | Nurse Anesthetist, Certified Registered | 30544 Highway 200 Ste 201, Pend Oreille Surgery Center, Ponderay, ID 83852-5005 | 2009-07-14 |
| 1932527389 | Stuart Gall Crna Inc | Nurse Anesthetist, Certified Registered | 30544 Highway 200, Suite 201, Ponderay, ID 83852-5005 | 2014-04-02 |
| 1376713008 | Bruce Demko Crna Inc | Nurse Anesthetist, Certified Registered | 30544 Highway 200, Ponderay, ID 83852-5005 | 2008-03-10 |
| 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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| 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.