Individual provider Active NPI

Fletcher M Stevenson, CRNA

  • Certified Registered Nurse Anesthetist
  • Huntington, WV
National Provider Identifier
1548236409
Registry record updated Jun 28, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
69677 Issued in WV
Practice address
2900 1St Ave
St Marys Hosptal Room 6019
Huntington, WV 25702-1241
Phone
(304) 399-0137
Fax
(304) 399-0138
NPI assigned
Feb 28, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 28, 2013

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X APN10713 TN
Certified Registered Nurse Anesthetist 367500000X RN143453 TN
Certified Registered Nurse Anesthetist 367500000X RN170816 GA
Certified Registered Nurse Anesthetist 367500000X 69677 WV Primary

Addresses

Primary practice location

2900 1St Ave
St Marys Hosptal Room 6019
Huntington, WV 25702-1241

Mailing address

2900 1St Ave
St Marys Hosptal Room 6019
Huntington, WV 25702-1241
Phone (304) 399-0137

Other identifiers 11

IdentifierTypeStateIssuer
270052997003OtherWVTRICARE GROUP
2802800MedicaidOH
1071314OtherWVBRICKSTREET
3810008135MedicaidWV
4078445OtherTNBCBS
0207026000MedicaidWV
001706470OtherWVMSBCBS GROUP
2460484MedicaidOH
001945814OtherWVMSBCBS
27005299700OtherWVBRICKSTREET GROUP
3630211MedicaidTN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WV, OH, IN3 enrollments

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
I20070307000076 WV Practitioner - Certified Registered Nurse Anesthetist (Crna) 7810987690 Reassigns benefits to 1 organization
I20100928000863 OH Practitioner - Certified Registered Nurse Anesthetist (Crna) 7810987690 Reassigns benefits to 1 organization
I20211227000710 IN Practitioner - Certified Registered Nurse Anesthetist (Crna) 7810987690 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2004
Medicare assignment
May accept Medicare assignment
Group practices
Clinical Colleagues IncGroup PAC ID 8729011333, 170 clinicians

Practice addresses (Care Compare)

1101 Michigan Ave
Loganport, IN 46947-1528
Phone (850) 497-6702

1260 E State Rd
Suite 205
Columbia City, IN 46725-9492
Phone (260) 248-9301

Hospital & facility affiliations

  • Memorial Hospital Hospital, Logansport, IN, CCN 150072

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
RN170816GAMDCertified Registered Nurse Anesthetist
APN10713TNMDCertified Registered Nurse Anesthetist
RN143453TNMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Iceland Anesthesia Management, LLC Nurse Anesthetist, Certified Registered CurrentSince Mar 1, 2023 Accepting new patients
Mercer County Joint Township Community Hospital CurrentSince Jun 1, 2023 Accepting new patients
Mercer County Joint Township Community Hospital CurrentSince Jun 1, 2023 Accepting new patients
Diagnostic Pathology, LLC Current Accepting new patients
Sheridan Healthcare of West Virginia Inc Nurse Anesthetist, Certified Registered PastSince May 21, 2023 Accepting new patients
Anesthesiologists Associated PC Nurse Anesthetist, Certified Registered Past Accepting new patients
Mid-Atlantic Anesthesia Consultants, LLC Nurse Anesthetist, Certified Registered Past Accepting new patients
Anesthesiologists Associated PC Past Accepting new patients
Cardiac Anesthesia Plus, Inc. PastSince Jun 1, 2004 Accepting new patients

Locations

801 S Main St
Clinton, IN 47842
Phone (765) 832-1212

441 N Wabash Ave
Marion, IN 46952
Phone (219) 482-4577

1421 N 7th St
Terre Haute, IN 47807
Phone (812) 231-4604

800 W Main St
Coldwater, OH 45828
Phone (419) 678-2341

Organizations & group practices 10

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": "1141084800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1372377600000",
    "number": "1548236409",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2900 1ST AVE",
            "address_2": "ST MARYS HOSPTAL ROOM 6019",
            "city": "HUNTINGTON",
            "state": "WV",
            "postal_code": "257021241",
            "telephone_number": "304-399-0137",
            "fax_number": "304-399-0138"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2900 1ST AVE",
            "address_2": "ST MARYS HOSPTAL ROOM 6019",
            "city": "HUNTINGTON",
            "state": "WV",
            "postal_code": "257021241",
            "telephone_number": "304-399-0137",
            "fax_number": "304-399-0138"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STEVENSON",
        "first_name": "FLETCHER",
        "middle_name": "M",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-28",
        "last_updated": "2013-06-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "TN",
            "license": "APN10713",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "TN",
            "license": "RN143453",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "GA",
            "license": "RN170816",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "WV",
            "license": "69677",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE GROUP",
            "identifier": "270052997003",
            "state": "WV"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2802800",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BRICKSTREET",
            "identifier": "1071314",
            "state": "WV"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3810008135",
            "state": "WV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "4078445",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0207026000",
            "state": "WV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MSBCBS GROUP",
            "identifier": "001706470",
            "state": "WV"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2460484",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MSBCBS",
            "identifier": "001945814",
            "state": "WV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BRICKSTREET GROUP",
            "identifier": "27005299700",
            "state": "WV"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3630211",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Huntington, WV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 2013; 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.