Individual provider Active NPI

Jeannine Catherine Heiss Wunderlich, CRNA

  • Certified Registered Nurse Anesthetist
  • Fort Myers, FL
National Provider Identifier
1356662944
Registry record updated Jan 19, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
ARNP2811442 Issued in FL
Practice address
6820 International Center Blvd
Fort Myers, FL 33912-7129
Phone
(239) 360-8000
NPI assigned
Jun 17, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 19, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X ARNP2811442 FL Primary

Addresses

Primary practice location

6820 International Center Blvd
Fort Myers, FL 33912-7129

Mailing address

14013 Clear Water LN
Fort Myers, FL 33907-8097
Phone (239) 281-4627

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101020000941 FL Practitioner - Certified Registered Nurse Anesthetist (Crna) 2769675974 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
FMFL Anesthesia LLCGroup PAC ID 1153752811, 15 clinicians

Practice addresses (Care Compare)

6820 International Ctr Blvd
Fort Myers, FL 33912-7129
Phone (239) 210-0301

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ARNP2811442FLMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Anesthesia & Pain Consultants of SW FL CurrentSince Aug 2, 2010 Accepting new patients
FMFL Anesthesia, LLC Nurse Anesthetist, Certified Registered CurrentSince Apr 1, 2020 Accepting new patients
US Anesthesia Partners of Florida Inc. Nurse Anesthetist, Certified Registered CurrentSince Dec 17, 2019 Accepting new patients
Outpatient Anesthesia of Southwest Florida Inc PastSince Jan 1, 2013 Accepting new patients

Locations

2776 Cleveland Ave
Fort Myers, FL 33901
Phone (239) 343-2000

4035 Evans Ave
Fort Myers, FL 33901
Phone (941) 939-4937

12511 World Plaza Ln
Bldg 50
Fort Myers, FL 33907
Phone 2399392622 ext. 300

6820 International Center Blvd
Fort Myers, FL 33912
Phone (239) 210-0301

601 E Rollins St
Orlando, FL 32803
Phone (407) 303-1996

1000 Waterman Way
Tavares, FL 32778
Phone (352) 253-3333

Organizations & group practices 4

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": "1276732800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1611014400000",
    "number": "1356662944",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14013 CLEAR WATER LN",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339078097",
            "telephone_number": "239-281-4627"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6820 INTERNATIONAL CENTER BLVD",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339127129",
            "telephone_number": "239-360-8000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WUNDERLICH",
        "first_name": "JEANNINE",
        "middle_name": "CATHERINE HEISS",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-06-17",
        "last_updated": "2021-01-19",
        "certification_date": "2021-01-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "FL",
            "license": "ARNP2811442",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Myers, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 2021; 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.