Individual provider Active NPI

Peter John Fecht, CRNA

  • Certified Registered Nurse Anesthetist
  • Moline, IL
National Provider Identifier
1144224429
Registry record updated Feb 28, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
209000285 Issued in IL
Practice address
545 Valley View Dr
Moline, IL 61265-6138
Phone
(309) 762-5560
Fax
(309) 762-7351
NPI assigned
Jun 2, 2005
Last updated
Feb 28, 2014By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 28, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 209000285 IL Primary

Addresses

Primary practice location

545 Valley View Dr
Moline, IL 61265-6138

Mailing address

545 Valley View Dr
Moline, IL 61265-6138
Phone (309) 762-5560

Other identifiers 2

IdentifierTypeStateIssuer
344565702MedicaidIL
430078437OtherILRAILROAD MEDICARE

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080212000038 IL Practitioner - Certified Registered Nurse Anesthetist (Crna) 7911080114 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Osf Multi-Specialty GroupGroup PAC ID 3678889789, 2,123 clinicians

Practice addresses (Care Compare)

3333 N Seminary St
Galesburg, IL 61401-1251
Phone (309) 344-3161

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
209000285ILMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
McDonough County Hospital District Current Accepting new patients
Moline Anesthesia PLLC Nurse Anesthetist, Certified Registered CurrentSince Apr 15, 2019 Accepting new patients
McDonough County Hospital District CurrentSince Aug 29, 2011 Accepting new patients
McDonough County Hospital District Current Accepting new patients
Hammond Henry Dist Hospital CurrentSince Dec 19, 2016 Accepting new patients
Osf Healthcare System CurrentSince Mar 25, 2019 Accepting new patients
Central PA Pharmacy LLC. Current Accepting new patients
McDonough County Hospital District Current Accepting new patients
McDonough County Hospital District Current Accepting new patients
Hammond Henry Dist Hospital CurrentSince Dec 19, 2016 Accepting new patients
McDonough County Hospital District Current Accepting new patients
Osf Healthcare System Nurse Anesthetist, Certified Registered Current Accepting new patients
McDonough County Hospital District Nurse Anesthetist, Certified Registered CurrentSince Aug 29, 2011 Accepting new patients
Osf Multi-Specialty Group CurrentSince Aug 1, 2021 Accepting new patients
Osf Healthcare System Nurse Anesthetist, Certified Registered CurrentSince Mar 25, 2019 Accepting new patients
Hammond Henry Dist Hospital Past Accepting new patients

Locations

3333 N Seminary St
Galesburg, IL 61401
Phone (309) 344-3161

600 N College Ave
Geneseo, IL 61254
Phone (309) 944-6431

1051 W South St
Kewanee, IL 61443
Phone (309) 734-3141

525 E Grant St
Macomb, IL 61455
Phone (309) 836-1611

545 Valley View Dr
Moline, IL 61265
Phone (309) 277-1180

1000 W Harlem Ave
Monmouth, IL 61462
Phone (309) 734-1414

8600 State Route 91
Ste 130
Peoria, IL 61615
Phone (309) 683-5050

Interoperability endpoints

  • FHIR API: https://fhir-myrecord.cerner.com/r4/9c9d3cdf-0f7f-4b63-979a-f711747b3e95/

Organizations & group practices 16

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.

View all 16

Hospital & facility affiliations 3

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": "1117670400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1393545600000",
    "number": "1144224429",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "545 VALLEY VIEW DR",
            "city": "MOLINE",
            "state": "IL",
            "postal_code": "612656138",
            "telephone_number": "309-762-5560",
            "fax_number": "309-762-7351"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "545 VALLEY VIEW DR",
            "city": "MOLINE",
            "state": "IL",
            "postal_code": "612656138",
            "telephone_number": "309-762-5560",
            "fax_number": "309-762-7351"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FECHT",
        "first_name": "PETER",
        "middle_name": "JOHN",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-02",
        "last_updated": "2014-02-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "IL",
            "license": "209000285",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "344565702",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "430078437",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Moline, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 28, 2014; 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.