Gary Allan Fennig Jr., DO

Primary specialty

Anesthesiology PhysicianTaxonomy code 207L00000X

License

OS17262 Issued in FL

Practice address

1600 Lakeland Hills Blvd
Lakeland, FL 33805-3019

Phone

(863) 680-7000

Fax

(866) 264-8519

NPI assigned

Mar 24, 2009

Sex

Male

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Anesthesiology

Education

Ohio University, College of Osteopathic Medicine, 2009

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Watson Clinic LLPGroup PAC ID 1456258979, 365 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Bartow Regional Medical Center Hospital, Bartow, FL, CCN 100121

Merit-based Incentive Payment System (MIPS)

Final score

87.18 of 100Reported as apm

Quality

70.68

Promoting interoperability

100

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

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.

• Watson Clinic LLP

  • Internal Medicine Physician
  • Lakeland, FL
  • NPI 1316940695
  Medicare reassignment Care Compare group NPD
• Greater Florida Anesthesiologists, LLC

  • Anesthesiology Physician
  • Safety Harbor, FL
  • NPI 1528630795
  NPD

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

• Bartow Regional Medical Center, Inc.

  • General Acute Care Hospital
  • Bartow, FL
  • NPI 1558734095
  Care Compare affiliation

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

{
    "created_epoch": "1237852800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643673600000",
    "number": "1225279151",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1600 LAKELAND HILLS BLVD",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "338053019",
            "telephone_number": "863-680-7000",
            "fax_number": "866-264-8519"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 LAKELAND HILLS BLVD",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "338053019",
            "telephone_number": "863-680-7000",
            "fax_number": "866-264-8519"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FENNIG",
        "first_name": "GARY",
        "middle_name": "ALLAN",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-03-24",
        "last_updated": "2022-02-01",
        "certification_date": "2022-02-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "OH",
            "license": "34 010736",
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "FL",
            "license": "17262",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "FL",
            "license": "OS17262",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cheryl Dawn Fellas, LMHC
• Theresa Lynn Felten, MD
• Nancy A Fenelus
• Susan Baltich Fenich, LMHC
• Alivia Joleigh Fenner, RBT
• Sabrina Ferguson-Gilzean, RPH
• Alexis Ferguson, M.D.
• John Scott Ferguson, D.O.
• Philip John Ferkler, M.D.
• Amber Haley Fernandez, CRNA

• Anesthesiology Physician in Lakeland, FL
• Providers in Lakeland, FL by specialty
• Anesthesiology Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.