Gregory Fenn, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA9108811 Issued in FL

Practice address

918 NW 120TH St
Gainesville, FL 32606-0438

Phone

(352) 359-5162

NPI assigned

Jun 24, 2015

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

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: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

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.

• Florida Clinical Practice Association Inc

  • Surgery Physician
  • Gainesville, FL
  • NPI 1063463768
  Medicare reassignment NPD
• Cep America, LLC

  • Emergency Medicine Physician
  • Miramar Beach, FL
  • NPI 1295442614
  Medicare reassignment
• Emergency Medical Specialists of Jacksonville

  • Emergency Medicine Physician
  • Jacksonville, FL
  • NPI 1295738367
  Medicare reassignment
• St Vincent'S Full Service Urgent Care, LLC

  • Occupational Medicine Clinic/Center
  • Jacksonville, FL
  • NPI 1750672051
  Medicare reassignment
• Cep America LLC

  • Emergency Medicine Physician
  • Fort Lauderdale, FL
  • NPI 1700747946
  NPD
• Cep America LLC

  • Emergency Medicine Physician
  • Pensacola, FL
  • NPI 1770345266
  NPD
• Florida Clinical Practice Association Inc

  • Durable Medical Equipment & Medical Supplies
  • Ocala, FL
  • NPI 1609529478
  NPD

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

{
    "created_epoch": "1435104000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1441670400000",
    "number": "1225410426",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 100186",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326100186",
            "telephone_number": "352-265-5911"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "918 NW 120TH ST",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326060438",
            "telephone_number": "352-359-5162"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FENN",
        "first_name": "GREGORY",
        "name_prefix": "Mr.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-06-24",
        "last_updated": "2015-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9108811",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "015332300",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Charlene Felser, O.D.
• George Tucker Felts, RBT
• Lauren Feltz, M.H.SC, AA-C
• Ann-Marie Fenn, ARNP/LCSW
• Claire Cecilia Fenn, MAOM
• Jerry Daniel Fenn, MD, PHD
• Jennifer Fennell
• Robert S Fennell III, MD
• Nicholas Clarke Feranec, MD
• Jacqueline Ferber

• Physician Assistant in Gainesville, FL
• Providers in Gainesville, FL by specialty
• Physician Assistant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2015; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.