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SOUTHERN F BOLLER CRNA
NPI 1811828254
Nurse Anesthetist, Certified Registered in Kearney, NE

Active since May 26, 2026Accepts Medicare Assignment
10 E 31ST ST, KEARNEY, NE 68847(308) 865-7100 Get Directions Write a Review

NPPES record last updated: May 26, 2026. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Southern F Boller Crna NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SOUTHERN F BOLLER CRNA (NPI 1811828254) is an individual nurse anesthetist, certified registered in Kearney, Nebraska, licensed in Nebraska (101999) and active in the NPI registry since May 2026. She is a graduate of Other (2026).

NPPES Registry Identity

NPI1811828254
Entity TypeIndividualFemale
Primary Taxonomy367500000X
Provider Legal NameSOUTHERN F BOLLERCredential: CRNA
Location Address10 E 31ST STKearney, NE 68847-2908
Mailing AddressPo Box 1771Kearney, NE 68848-1771 · (308) 236-5506 · Fax (308) 236-7089
Phone(308) 865-7100
Sole ProprietorNo
Medical School CMSOtherGraduated 2026
Enumeration DateMay 26, 2026
NPPES CertifiedMay 26, 2026
✔ NPI 1811828254 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Anesthetist, Certified RegisteredPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code367500000X
License✔ Licensed in NE · 101999
Definition
(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.
10 E 31ST ST, Kearney, NE 68847
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Southern F Boller Crna is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID2466924329
PECOS Enrollment IDI20260611003986

Medicare Billing Reassignment

Medicare enrollment records show Southern Boller reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Kearney Anesthesia Associates PC
9.9 mi
Nurse Anesthetist, Certified Registered
115 E 52ND ST
Kearney, NE 68847
  • Reassigned Medicare billing, Nebraska enrollment
  • 36 clinicians in this Medicare group
NPI 1578593752 (308) 236-5506

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 68847 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$121.35 typical visit price
range $52.69 – $160.21
Typical copayment $30.33 (range $13.17 – $40.05)
Most-billed visit code 99204
Established Patient
$66.00 typical visit price
range $16.90 – $131.25
Typical copayment $16.50 (range $4.22 – $32.81)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MIKAELA ANGELA MEJIA SIM RN
Registered Nurse (Critical Care Medicine)
10 E 31ST ST
KEARNEY, NE 68847
Buffalo County (308) 865-7100
GOOD SAMARITAN HOSPITAL
Skilled Nursing Facility
10 E 31ST ST
KEARNEY, NE 68847
Buffalo County (308) 865-7900
DR. JOHN S WATERS M.D.
Internal Medicine (Interventional Cardiology)
10 E 31ST ST
KEARNEY, NE 68847
Buffalo County (308) 865-7100
KATI RENAE MOORE
Physician Assistant
10 E 31ST ST
KEARNEY, NE 68847
Buffalo County (308) 737-5284
LEERA MARIE DUTTON
Nurse Practitioner (Acute Care)
10 E 31ST ST
KEARNEY, NE 68847
Buffalo County (308) 865-7100
MRS. JACQUELINE D LIESS APRN (NNP-BC)
Nurse Practitioner (Neonatal, Critical Care)
10 E 31ST ST
KEARNEY, NE 68847
Buffalo County (308) 865-7139
DANIEL L FUERST MD
Radiology (Diagnostic Radiology)
10 E 31ST ST
KEARNEY, NE 68847
Buffalo County (308) 234-5520
DANIEL D MOOS CRNA
Nurse Anesthetist, Certified Registered
10 E 31ST ST
KEARNEY, NE 68847
Buffalo County (308) 236-5506

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Southern Boller's NPI number?

The NPI number for Southern Boller is 1811828254. It was assigned to this individual provider in the NPPES registry on May 26, 2026.

Where is Southern Boller located?

Southern Boller practices at 10 E 31st St, Kearney, NE 68847. The listed phone number is (308) 865-7100.

What is Southern Boller's specialty?

The primary specialty registered for this NPI is Nurse Anesthetist, Certified Registered with taxonomy code 367500000X.

Is Southern Boller enrolled in Medicare?

Yes. Southern Boller is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Which organization bills Medicare for Southern Boller's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Southern Boller reassigns Medicare benefits to Kearney Anesthesia Associates PC (Kearney, NE). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Southern Boller's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Southern Boller was last updated on May 26, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.