Individual provider Active NPI

Gregory Allan Fenchel Jr., CRNA

  • Certified Registered Nurse Anesthetist
  • Amarillo, TX
National Provider Identifier
1104431576
Registry record updated Oct 8, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
1011950 Issued in TX
Practice address
1501 S Coulter St
Amarillo, TX 79106-1770
Phone
(806) 354-1000
NPI assigned
Sep 12, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 8, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Certified Registered Nurse Anesthetist 367500000X 1011950 TX Primary

Addresses

Primary practice location

1501 S Coulter St
Amarillo, TX 79106-1770

Mailing address

7550 Hillside Rd Apt 1101
Amarillo, TX 79119-8316
Phone (505) 306-6869

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20201015001990 TX Practitioner - Certified Registered Nurse Anesthetist (Crna) 1759701501 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Independent Physicians Network PLLCGroup PAC ID 5496029407, 218 clinicians
McOn Anesthesia PLLCGroup PAC ID 3173008059, 53 clinicians

Practice addresses (Care Compare)

3300 Oak Lawn Ave
Suite 200
Dallas, TX 75219-4265
Phone (214) 252-3501

3625 N Hall St
Suite 800
Dallas, TX 75219-5106
Phone (800) 411-7515

Hospital & facility affiliations

  • Northwest Texas Hospital Hospital, Amarillo, TX, CCN 450209

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
1011950TXMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Independent Physicians Network PLLC CurrentSince Oct 8, 2020 Accepting new patients

Locations

1501 S Coulter St
Amarillo, TX 79106
Phone (800) 354-1150

3625 N Hall St
Ste 800
Dallas, TX 75219
Phone (214) 252-3500

3300 Oak Lawn Ave
Ste 200
Dallas, TX 75219
Phone (214) 252-3500

6200 W Parker Rd
Plano, TX 75093
Phone (972) 608-8000

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 and National Provider Directory roles.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1599868800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1602115200000",
    "number": "1104431576",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7550 HILLSIDE RD APT 1101",
            "city": "AMARILLO",
            "state": "TX",
            "postal_code": "791198316",
            "telephone_number": "505-306-6869"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1501 S COULTER ST",
            "city": "AMARILLO",
            "state": "TX",
            "postal_code": "791061770",
            "telephone_number": "806-354-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FENCHEL",
        "first_name": "GREGORY",
        "middle_name": "ALLAN",
        "name_suffix": "Jr.",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-09-12",
        "last_updated": "2020-10-08",
        "certification_date": "2020-10-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "TX",
            "license": "1011950",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Amarillo, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 2020; 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.

Verify at the official NPI Registry.