Active NPI
Mark Thetford
- Certified Registered Nurse Anesthetist
- Fort Myers, FL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Certified Registered Nurse Anesthetist
- License
- ARNP9397749
- Practice address
- 13681 Doctors Way
Fort Myers, FL 33912-4300 - Phone
- (239) 343-1000
- NPI assigned
- Sep 27, 2017
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | RN9397749 | FL | |
| Certified Registered Nurse Anesthetist | 367500000X | ARNP9397749 | FL | Primary |
Addresses
Primary practice location
13681 Doctors Way
Fort Myers, FL 33912-4300
Mailing address
11131 Everblades Pkwy
Estero, FL 33928-9546
Phone (618) 889-8220
Other practice location 1
13681 Doctors Way
Fort Myers, FL 33912-4300
Phone (239) 343-1000
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in FL, IL
Enrollment records 2
Care Compare profile
Medicare Care Compare- Specialty
- Certified Registered Nurse Anesthetist (Crna)
- Education
- Other, 2013
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
13681 Doctors Way
Fort Myers, FL 33912-4300
Phone (239) 343-1000
201 S 14TH St
Herrin, IL 62948-3631
Phone (618) 942-2171
Hospital & facility affiliations
- Gulf Coast Medical Center Lee Health
- Memorial Hospital of Carbondale
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Certified Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RN9397749 | FL | MD | Registered Nurse |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| American Anesthesiology Services of Florida, Inc. | Current | Accepting new patients | |
| Northstar Anesthesia of Illinois, LLC | Nurse Anesthetist, Certified Registered | Current | Accepting new patients |
| US Anesthesia Partners of Florida Inc. | Nurse Anesthetist, Certified Registered | Current | Accepting new patients |
| Anesthesia & Pain Consultants of SW FL | Current | Accepting new patients | |
| Outpatient Anesthesia of Southwest Florida Inc | Past | Accepting new patients |
Locations
13500 Powers Ct
Ste 230
Fort Myers, FL 33912
Phone (239) 610-0784
2776 Cleveland Ave
Fort Myers, FL 33901
Phone (239) 343-2000
4035 Evans Ave
Fort Myers, FL 33901
Phone (941) 939-4937
13681 Doctors Way
Fort Myers, FL 33912
Phone (239) 343-1000
12511 World Plaza Ln
Bldg 50
Fort Myers, FL 33907
Phone 2399392622 ext. 300
4725 N Federal Hwy
Oakland Park, FL 33308
Phone (954) 493-5005
601 E Rollins St
Orlando, FL 32803
Phone (407) 303-1996
6901 Simmons Loop
Riverview, FL 33578
Phone (813) 302-8000
400 Health Park Blvd
St Augustine, FL 32086
Phone (904) 819-4300
1000 Waterman Way
Tavares, FL 32778
Phone (352) 253-3333
405 W Jackson St
Carbondale, IL 62901
201 S 14th St
Herrin, IL 62948
Phone (618) 942-2171
1423 Chicago Rd
Sauk Village, IL 60411
Phone (708) 679-2160
1305 Walt Whitman Rd
Ste 300
Melville, NY 11747
Phone (516) 370-3796
Organizations & group practices 5
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Anesthesiology Physician
- Melville, NY
- NPI 1508318387
FL
-
- Anesthesiology Physician
- Arlington, TX
- NPI 1962822395
IL, Nurse Anesthetist, Certified Registered
-
- Specialist
- Fort Myers, FL
- NPI 1609843275
-
- Anesthesiology Physician
- Maitland, FL
- NPI 1518910520
Nurse Anesthetist, Certified Registered
-
- Specialist
- Fort Myers, FL
- NPI 1518244383
Hospital & facility affiliations 2
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Fort Myers, FL
- NPI 1366281750
-
- General Acute Care Hospital
- Carbondale, IL
- NPI 1093801797
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1506470400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1521244800000",
"number": "1104335660",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11131 EVERBLADES PKWY",
"city": "ESTERO",
"state": "FL",
"postal_code": "339289546",
"telephone_number": "618-889-8220"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "13681 DOCTORS WAY",
"city": "FORT MYERS",
"state": "FL",
"postal_code": "339124300",
"telephone_number": "239-343-1000"
}
],
"practiceLocations": [
{
"address_1": "13681 Doctors Way",
"address_purpose": "LOCATION",
"city": "Fort Myers",
"state": "FL",
"postal_code": "339124300",
"country_code": "US",
"telephone_number": "239-343-1000",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "THETFORD",
"first_name": "MARK",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2017-09-27",
"last_updated": "2018-03-17",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "FL",
"license": "RN9397749",
"primary": false
},
{
"code": "367500000X",
"taxonomy_group": "",
"desc": "Nurse Anesthetist, Certified Registered",
"state": "FL",
"license": "ARNP9397749",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Fort Myers, FL
- Therapeutic Massage of Southwest Florida, Inc.
- Therapeutic Skin Care and Massage Center
- Therapy First LLC
- Therapy Treatment Team LLC
- Therapy Treatment Team, LLC
- William Hamilton Thetford, DPM
- Donald W. Thibodeau, B.S., R.PH., PHARMD
- Jenna Dees Thibodeau, P.A.-C
- Hannah Marie Thielman, LMHC
- Tracy Thigpen
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.