Active NPI
Deborah D Flettrich, RN/CRNA
- Certified Registered Nurse Anesthetist
- Memphis, TN
National Provider Identifier
1265446884
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Certified Registered Nurse Anesthetist
- License
- 11657
- Practice address
- 262 Danny Thomas PL
Memphis, TN 38105-3678 - Phone
- (901) 595-3006
- Fax
- (901) 595-3842
- NPI assigned
- Jul 28, 2006
- Sex
- Female
- 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 | 73516 | TN | |
| Certified Registered Nurse Anesthetist | 367500000X | 11657 | TN | Primary |
Addresses
Primary practice location
262 Danny Thomas PL
Memphis, TN 38105-3678
Mailing address
262 Danny Thomas PL
Ms 515
Memphis, TN 38105-3678
Phone (901) 595-3006
Other identifiers 7
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 159246001 | Medicaid | AR | |
| 1555738 | Medicaid | LA | |
| 200803610A | Medicaid | IN | |
| 5440665 | Medicaid | TN | |
| 200071170A | Medicaid | OK | |
| 917570509 | Medicaid | MO | |
| 09631271 | Medicaid | MS |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TN
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Certified Registered Nurse, Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 11657 | TN | MD | Dentist |
| 73516 | TN | MD | Registered Nurse |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| St Jude Children'S Research Hospital, Inc. | Nurse Anesthetist, Certified Registered | Current | Accepting new patients |
Locations
262 Danny Thomas Pl
Memphis, TN 38105
Phone (888) 226-4343
262 Danny Thomas Pl
#515
Memphis, TN 38105
Phone (901) 495-3006
Organizations & group practices 1
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.
-
- Pediatrics Physician
- Memphis, TN
- NPI 1306335088
Nurse Anesthetist, Certified Registered
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1154044800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1736726400000",
"number": "1265446884",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "262 DANNY THOMAS PL",
"address_2": "MS 515",
"city": "MEMPHIS",
"state": "TN",
"postal_code": "381053678",
"telephone_number": "901-595-3006",
"fax_number": "901-595-3842"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "262 DANNY THOMAS PL",
"city": "MEMPHIS",
"state": "TN",
"postal_code": "381053678",
"telephone_number": "901-595-3006",
"fax_number": "901-595-3842"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FLETTRICH",
"first_name": "DEBORAH",
"middle_name": "D",
"credential": "RN/CRNA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-07-28",
"last_updated": "2025-01-13",
"certification_date": "2025-01-13",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "TN",
"license": "73516",
"primary": false
},
{
"code": "367500000X",
"taxonomy_group": "",
"desc": "Nurse Anesthetist, Certified Registered",
"state": "TN",
"license": "11657",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "159246001",
"state": "AR"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1555738",
"state": "LA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "200803610A",
"state": "IN"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "5440665",
"state": "TN"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "200071170A",
"state": "OK"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "917570509",
"state": "MO"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "09631271",
"state": "MS"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Memphis, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.