NPIMap

Organization Active NPI

Amsurg Fresno Ca Anesthesia LP

  • Anesthesiology Physician
  • Fresno, CA
National Provider Identifier
1104246065
Registry record updated Aug 9, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
Legal business name
AMSURG FRESNO CA ANESTHESIA LP
Practice address
7055 N Fresno St
Suite 100
Fresno, CA 93720-2957
Phone
(559) 440-9100
Fax
(559) 448-8363
NPI assigned
Apr 18, 2014
Last updated
Aug 9, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 9, 2016

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

Authorized official

Name
Mr. Phillip A Clendenin
Title
President
Phone
(615) 665-1283

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207L00000X CA Primary

Addresses

Primary practice location

7055 N Fresno St
Suite 100
Fresno, CA 93720-2957

Mailing address

1A Burton Hills Blvd
Attn: Provider Enrollment
Nashville, TN 37215-6187
Phone (615) 240-3809

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20140930001363 CA Part B Supplier - Clinic/Group Practice 8729208566 Receives reassigned benefits from 29 practitioners
Practice locations: Fresno, CA

National Provider Directory

National Provider Directory

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 29

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 29

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1397779200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1470700800000",
    "number": "1104246065",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1A BURTON HILLS BLVD",
            "address_2": "ATTN: PROVIDER ENROLLMENT",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372156187",
            "telephone_number": "615-240-3809",
            "fax_number": "615-234-1809"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7055 N FRESNO ST",
            "address_2": "SUITE 100",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937202957",
            "telephone_number": "559-440-9100",
            "fax_number": "559-448-8363"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AMSURG FRESNO CA ANESTHESIA LP",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-04-18",
        "last_updated": "2016-08-09",
        "status": "A",
        "authorized_official_last_name": "CLENDENIN",
        "authorized_official_first_name": "PHILLIP",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "615-665-1283",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Anesthesiology",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fresno, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.