Elton G. Fennell, M.D.

Primary specialty

Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X

License

235209 Issued in MA

Practice address

415 W Columbia St
Ste 110
Evansville, IN 47710-1656

Phone

(812) 450-3363

Fax

(812) 450-3071

NPI assigned

May 10, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Other identifiers 2

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in MN, WI, MA, KY, MI5 enrollments

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 5

Specialty

Obstetrics/GynecologyAlso: Family Practice

Education

Other, 1982

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Dean Health Systems IncGroup PAC ID 7012827983, 1,174 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: efennell74599@direct.deaconess.com
• Direct secure messaging: elton.fennell@direct.signature.masshiway.net

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.

• Dean Health Systems, Inc

  • Allergy & Immunology Physician
  • Madison, WI
  • NPI 1053358846

  Family Medicine

  Medicare reassignment Care Compare group NPD
• Henry Heywood Memorial Hospital

  • General Acute Care Hospital
  • Gardner, MA
  • NPI 1205823879

  Family Medicine

  Medicare reassignment NPD
• Heywood Medical Group Inc.

  • General Practice Physician
  • Gardner, MA
  • NPI 1699762286

  Family Medicine

  Medicare reassignment NPD
• Michael J Grossman MD PC

  • Obstetrics & Gynecology Physician
  • North Andover, MA
  • NPI 1770530255
  Medicare reassignment NPD
• Nantucket Cottage Hospital

  • Rural Acute Care Hospital
  • Nantucket, MA
  • NPI 1447214622
  Medicare reassignment NPD
• Nantucket Physicians Organization

  • Orthopaedic Surgery Physician
  • Nantucket, MA
  • NPI 1568798510

  Family Medicine

  Medicare reassignment NPD
• Obhg Kentucky, P.S.C.

  • Obstetrics & Gynecology Physician
  • Ashland, KY
  • NPI 1457644122
  Medicare reassignment NPD
• Obhg Massachusetts - Direct, P.C.

  • Obstetrics Physician
  • Brockton, MA
  • NPI 1487229035
  Medicare reassignment NPD
• Obhg Massachusetts PC

  • Obstetrics & Gynecology Physician
  • Lawrence, MA
  • NPI 1740844083
  Medicare reassignment NPD
• Prairie Du Chien Memorial Hospital Association Inc

  • Critical Access Hospital
  • Prairie Du Chien, WI
  • NPI 1619024197
  Medicare reassignment NPD
• Sanford Health Network

  • Critical Access Hospital
  • Luverne, MN
  • NPI 1497703045
  Medicare reassignment NPD
• Steward Medical Group, Inc

  • Specialist
  • Watertown, MA
  • NPI 1629398219
  Medicare reassignment NPD

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

{
    "created_epoch": "1147219200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757548800000",
    "number": "1497705891",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3407",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "477333407",
            "telephone_number": "812-450-3363",
            "fax_number": "812-450-3071"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "415 W COLUMBIA ST",
            "address_2": "STE 110",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "477101656",
            "telephone_number": "812-450-3363",
            "fax_number": "812-450-3071"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "420 N Sawyer Rd",
            "address_purpose": "LOCATION",
            "city": "Kendallville",
            "state": "IN",
            "postal_code": "467552572",
            "country_code": "US",
            "telephone_number": "260-347-8030",
            "fax_number": "260-347-8035",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3400 E Racine St",
            "address_purpose": "LOCATION",
            "city": "Janesville",
            "state": "WI",
            "postal_code": "535462344",
            "country_code": "US",
            "telephone_number": "608-373-8000",
            "fax_number": "608-371-8928",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FENNELL",
        "first_name": "ELTON",
        "middle_name": "G.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-10",
        "last_updated": "2025-09-11",
        "certification_date": "2025-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "IN",
            "license": "01074892A",
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "WI",
            "license": "45090",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IN",
            "license": "01074892A",
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "MA",
            "license": "235209",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2157934",
            "state": "MA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1497705891",
            "state": "WI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "efennell508701@direct-ehr-ssmhc.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "efennell508701@direct-ehr-ssmhc.com",
            "address_1": "3400 E Racine St",
            "city": "Janesville",
            "state": "WI",
            "country_code": "US",
            "postal_code": "535462344",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Joel D Fehsenfeld, LCSW
• Andrei Feldiorean, MB BCH BAO
• Leslee Feller, LSW
• Serena A Feller, LCSW
• Kynnedi Fellows
• Phyllis Ann Fenneman, PHYSICAL THERAPIST
• Brandi S Fenwick
• Cody Fenwick, LCSW
• Veronica L. Fenwick, DPT
• Sara Gayle Fergus

• Obstetrics & Gynecology Physician in Evansville, IN
• Providers in Evansville, IN by specialty
• Obstetrics & Gynecology Physician in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; 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.
• 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.