Michael S Fennell, M.D.

Primary specialty

Diagnostic Radiology PhysicianTaxonomy code 2085R0202X

License

MD21793 Issued in OR

Practice address

842 E Main St
Medford, OR 97504-7134

Phone

(541) 773-2493

Fax

(541) 779-3027

NPI assigned

Apr 3, 2006

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

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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

{
    "created_epoch": "1144022400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1394496000000",
    "number": "1336101690",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "842 E MAIN ST",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "975047134",
            "telephone_number": "541-773-2493",
            "fax_number": "541-779-3027"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "842 E MAIN ST",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "975047134",
            "telephone_number": "541-773-2493",
            "fax_number": "541-779-3027"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FENNELL",
        "first_name": "MICHAEL",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-03",
        "last_updated": "2014-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "OR",
            "license": "MD21793",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "133931",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Martha Dale Feil
• Helene Feiner, OT
• Michael Fekete
• Evelyn Mann Fellows, M.S.
• Dan F Fennell, MD
• Kirsten Ferguson, SLP
• Lydia Kate Ferguson, RDH, EPP
• Olivia Marie Ferguson
• Fern Gardens Memory Care LLC
• Laura Korin Ferrara, L.M.T

• Diagnostic Radiology Physician in Medford, OR
• Providers in Medford, OR by specialty
• Diagnostic Radiology Physician in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2014; 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.