Individual provider Active NPI

Calvin Reed Fesler, MD

  • Pain Medicine (Physical Medicine & Rehabilitation) Physician
  • Loma Linda, CA
National Provider Identifier
1285169136
Registry record updated Apr 17, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine (Physical Medicine & Rehabilitation) PhysicianTaxonomy code 2081P2900X
License
65441 Issued in TN
Practice address
11234 Anderson St
Loma Linda, CA 92354-2804
Phone
(909) 558-6202
NPI assigned
Apr 28, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 17, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Pain Medicine (Physical Medicine & Rehabilitation) Physician 2081P2900X 65441 TN Primary

Addresses

Primary practice location

11234 Anderson St
Loma Linda, CA 92354-2804

Mailing address

11234 Anderson St
Gme Office Westerly Suite C
Loma Linda, CA 92354-2804
Phone (909) 558-6202

Medicare participation

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

Enrollment IDStateProvider typePAC IDDetails
I20220614000499 TN Practitioner - Pain Management 0840679379 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pain Management
Education
Loma Linda University School of Medicine, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1009 N Locust Ave
Lawrenceburg, TN 38464-2746
Phone (571) 982-6636

55 Mouse Creek Rd NW
Cleveland, TN 37312-4840
Phone (423) 813-7333

9298 Apison Pike
Suite 100
Ooltewah, TN 37363-7268
Phone (423) 813-7333

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
65441TNMDPain Medicine (Physical Medicine & Rehabilitation) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Privia Medical Group Tennessee LLC CurrentSince Feb 1, 2023 Accepting new patients
Privia Medical Group Tennessee LLC CurrentSince Feb 1, 2023 Accepting new patients

Locations

55 Mouse Creek Rd NW
Cleveland, TN 37312
Phone (423) 478-8989

1009 N Locust Ave
Lawrenceburg, TN 38464
Phone (931) 244-7181

9298 Apison Pike
Ste 100
Ooltewah, TN 37363
Phone (423) 813-7333

Interoperability endpoints

  • Direct secure messaging: cfesler81350@direct.llu.edu
  • Direct secure messaging: calvin.fesler.1@25094.direct.athenahealth.com

Organizations & group practices 2

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": "1493337600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1650153600000",
    "number": "1285169136",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11234 ANDERSON ST",
            "address_2": "GME OFFICE WESTERLY SUITE C",
            "city": "LOMA LINDA",
            "state": "CA",
            "postal_code": "923542804",
            "telephone_number": "909-558-6202"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11234 ANDERSON ST",
            "city": "LOMA LINDA",
            "state": "CA",
            "postal_code": "923542804",
            "telephone_number": "909-558-6202"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FESLER",
        "first_name": "CALVIN",
        "middle_name": "REED",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-04-28",
        "last_updated": "2022-04-17",
        "certification_date": "2022-04-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2081P2900X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation, Pain Medicine",
            "state": "TN",
            "license": "65441",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Loma Linda, CA

Sources for this page

Verify at the official NPI Registry.