Individual provider Active NPI

Janice L Pfotenhauer, CRNA

  • Certified Registered Nurse Anesthetist
  • Phenix City, AL
National Provider Identifier
1093814816
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
1-116825 Issued in AL
Practice address
2401 St Andrews Way
Phenix City
Phenix City, AL 36867-7413
Phone
(334) 448-8179
NPI assigned
Sep 21, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X RN27929 MT
Certified Registered Nurse Anesthetist 367500000X 1-116825 AL Primary
Certified Registered Nurse Anesthetist 367500000X RN196515 GA
Certified Registered Nurse Anesthetist 367500000X 551327 TX

Addresses

Primary practice location

2401 St Andrews Way
Phenix City
Phenix City, AL 36867-7413

Mailing address

4401 Riverchase Dr.
Phenix City
Phenix City, AL 36867-7413

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1-116825ALMDCertified Registered Nurse Anesthetist
RN27929MTMDCertified Registered Nurse Anesthetist
551327TXMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Cochise Group Anesthesia Services, LLC Past Accepting new patients
Amsol Anesthetists of Georgia, LLC Nurse Anesthetist, Certified Registered Past Accepting new patients

Organizations & group practices 2

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": "1158796800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1093814816",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4401 RIVERCHASE DR.",
            "address_2": "PHENIX CITY",
            "city": "PHENIX CITY",
            "state": "AL",
            "postal_code": "368677413"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2401 ST ANDREWS WAY",
            "address_2": "PHENIX CITY",
            "city": "PHENIX CITY",
            "state": "AL",
            "postal_code": "368677413",
            "telephone_number": "334-448-8179"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PFOTENHAUER",
        "first_name": "JANICE",
        "middle_name": "L",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-21",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MT",
            "license": "RN27929",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "AL",
            "license": "1-116825",
            "primary": true
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "GA",
            "license": "RN196515",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "TX",
            "license": "551327",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Phenix City, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.