Individual provider Active NPI

Bette J Fenn, ANP

  • Family Nurse Practitioner
  • Anchorage, AK
National Provider Identifier
1447283767
Registry record updated Feb 5, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
294 Issued in AK
Practice address
3200 Providence Dr
Suite B111
Anchorage, AK 99508-4615
Phone
(907) 212-7997
Fax
(907) 212-8225
NPI assigned
Jul 9, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 5, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 294 AK Primary

Addresses

Primary practice location

3200 Providence Dr
Suite B111
Anchorage, AK 99508-4615

Mailing address

PO Box 4105
Portland, OR 97208-4105
Phone (866) 907-1068

Other identifiers 1

IdentifierTypeStateIssuer
1022406MedicaidAK

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address bfenn231592@ak.providencedirect.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AK
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130321000337 AK Practitioner - Nurse Practitioner 6901041961 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

3200 Providence Dr
Anchorage, AK 99508-4615
Phone (907) 562-2211

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Health & Services- Washington CurrentSince Dec 7, 2015 Accepting new patients
Providence Health & Services-Washington Past Accepting new patients

Locations

3200 Providence Dr
Ste B111
Anchorage, AK 99508
Phone (907) 212-7890

920 Compassion Cir
Anchorage, AK 99504
Phone (907) 212-9200

3200 Providence Dr
Anchorage, AK 99508
Phone (907) 261-3111

3300 Providence Dr
Ste B104
Anchorage, AK 99508
Phone (907) 212-7997

Interoperability endpoints

  • Direct secure messaging: bfenn231592@ak.providencedirect.org

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1152403200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1612483200000",
    "number": "1447283767",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4105",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972084105",
            "telephone_number": "866-907-1068",
            "fax_number": "425-917-9141"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3200 PROVIDENCE DR",
            "address_2": "SUITE B111",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995084615",
            "telephone_number": "907-212-7997",
            "fax_number": "907-212-8225"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FENN",
        "first_name": "BETTE",
        "middle_name": "J",
        "credential": "ANP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-09",
        "last_updated": "2021-02-05",
        "certification_date": "2021-02-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AK",
            "license": "294",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1022406",
            "state": "AK"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "bfenn231592@ak.providencedirect.org",
            "affiliation": "N",
            "address_1": "3300 Providence Dr Ste B104",
            "city": "Anchorage",
            "state": "AK",
            "country_code": "US",
            "postal_code": "995084690",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Anchorage, AK

Sources for this page

Verify at the official NPI Registry.