Individual provider Active NPI

Katherine Tegtmeyer, CRNA

  • Certified Registered Nurse Anesthetist
  • Springfield, OR
National Provider Identifier
1285029751
Registry record updated Apr 1, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
201501838 Issued in OR
Practice address
3333 Riverbend Dr
Springfield, OR 97477-8800
Phone
(541) 222-7300
NPI assigned
Apr 1, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 1, 2015

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 201501837 OR
Registered Nurse 163W00000X 0189385 CO
Certified Registered Nurse Anesthetist 367500000X 201501838 OR Primary

Addresses

Primary practice location

3333 Riverbend Dr
Springfield, OR 97477-8800

Mailing address

PO Box 460639
Denver, CO 80246-0639
Phone (303) 349-5647

Other names 1

  • Katherine Fout Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR, CO2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20150605001263 OR Practitioner - Certified Registered Nurse Anesthetist (Crna) 9638490378 Reassigns benefits to 2 organizations
I20190206002438 CO Practitioner - Certified Registered Nurse Anesthetist (Crna) 9638490378 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Anesthesia Associates Northwest LLCGroup PAC ID 7618908484, 80 clinicians

Practice addresses (Care Compare)

1330 Commercial St SE
Salem, OR 97302-4206
Phone (503) 763-1973

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0189385COMDRegistered Nurse
201501837ORMDRegistered Nurse
201501838ORMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
On-Site Anesthesia Services Inc Nurse Anesthetist, Certified Registered CurrentSince Feb 1, 2017 Accepting new patients
Anesthesia Associates Northwest LLC CurrentSince Jun 1, 2020 Accepting new patients
Glenwood Anesthesia Professionals, PC CurrentSince Dec 19, 2018 Accepting new patients

Locations

1906 Blake Ave
Glenwood Springs, CO 81601
Phone (970) 384-7033

833 Bennett Ave
Medford, OR 97504
Phone (541) 608-1994

120 NW 14th Ave
Ste 200
Portland, OR 97209
Phone (503) 771-1883

2435 NW Kline St
Roseburg, OR 97471
Phone (541) 672-2020

2480 Liberty St NE
Ste 120
Salem, OR 97301
Phone (503) 363-4355

1330 Commercial St SE
Salem, OR 97302
Phone (503) 763-1973

6464 SW Borland Rd
Ste A3
Tualatin, OR 97062
Phone (503) 292-8614

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1427846400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1427846400000",
    "number": "1285029751",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 460639",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802460639",
            "telephone_number": "303-349-5647"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3333 RIVERBEND DR",
            "city": "SPRINGFIELD",
            "state": "OR",
            "postal_code": "974778800",
            "telephone_number": "541-222-7300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TEGTMEYER",
        "first_name": "KATHERINE",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-04-01",
        "last_updated": "2015-04-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "OR",
            "license": "201501837",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CO",
            "license": "0189385",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "OR",
            "license": "201501838",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KATHERINE",
            "last_name": "FOUT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Springfield, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 2015; 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.