Active NPI
Rocky J Fletcher
- Certified Registered Nurse Anesthetist
- Waterloo, IA
National Provider Identifier
1558315325
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Certified Registered Nurse Anesthetist
- License
- D-058051
- Practice address
- 1825 Logan Ave
Waterloo, IA 50703-1999 - Phone
- (319) 235-3886
- Fax
- (319) 233-1630
- NPI assigned
- May 19, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Certified Registered Nurse Anesthetist | 367500000X | D-058051 | IA | Primary |
Addresses
Primary practice location
1825 Logan Ave
Waterloo, IA 50703-1999
Mailing address
233 W First St
Waconia, MN 55387
Phone (952) 442-9770
Other identifiers 5
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 43339 | Other | IA | WELLMARK INS PLAN |
| 10745 | Other | IA | MIDLANDS CHOICE |
| 2267047 | Medicaid | IA | |
| 26585 | Other | IA | BLUE CROSS OF IA |
| 421417307A6 | Other | IA | JOHN DEERE HEALTH INS |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| D-058051 | IA | MD | Certified Registered Nurse Anesthetist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1147996800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1201478400000",
"number": "1558315325",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "233 W FIRST ST",
"city": "WACONIA",
"state": "MN",
"postal_code": "55387",
"telephone_number": "952-442-9770",
"fax_number": "952-442-3620"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1825 LOGAN AVE",
"city": "WATERLOO",
"state": "IA",
"postal_code": "507031999",
"telephone_number": "319-235-3886",
"fax_number": "319-233-1630"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FLETCHER",
"first_name": "ROCKY",
"middle_name": "J",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-05-19",
"last_updated": "2008-01-28",
"status": "A"
},
"taxonomies": [
{
"code": "367500000X",
"taxonomy_group": "",
"desc": "Nurse Anesthetist, Certified Registered",
"state": "IA",
"license": "D-058051",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "WELLMARK INS PLAN",
"identifier": "43339",
"state": "IA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MIDLANDS CHOICE",
"identifier": "10745",
"state": "IA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "2267047",
"state": "IA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS OF IA",
"identifier": "26585",
"state": "IA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "JOHN DEERE HEALTH INS",
"identifier": "421417307A6",
"state": "IA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Waterloo, IA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.