Individual provider Active NPI

Tonya S Fenzl, C.N.M.

  • Advanced Practice Midwife
  • Trinity, FL
National Provider Identifier
1659703064
Registry record updated Nov 15, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Advanced Practice MidwifeTaxonomy code 367A00000X
License
71014602A Issued in IN
Practice address
2043 Little Rd
Trinity, FL 34655-4421
Phone
(727) 846-7000
NPI assigned
Aug 8, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 15, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Advanced Practice Midwife 367A00000X APRN9489996 FL
Advanced Practice Midwife 367A00000X RN393909 OH
Advanced Practice Midwife 367A00000X 71014602A IN Primary

Addresses

Primary practice location

2043 Little Rd
Trinity, FL 34655-4421

Mailing address

3300 S Fiske Blvd
Rockledge, FL 32955-4306
Phone (727) 316-6210

Other practice location 1

2439 Bee Ridge Rd
Sarasota, FL 34239-6304
Phone (941) 343-0609

Other identifiers 2

IdentifierTypeStateIssuer
OA244OtherFLMEDICARE HF
115505700MedicaidFL

Other names 1

  • Tonya S Burroughs Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231107000731 IN Practitioner - Certified Nurse Midwife (CNM) 7315172715 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
APRN9489996FLMDAdvanced Practice Midwife
71014602AINMDAdvanced Practice Midwife
RN393909OHMDAdvanced Practice Midwife

Practice roles

OrganizationSpecialtyStatusNew patients
Seven Hills OB-GYN Associates LLC CurrentSince Nov 18, 2023 Accepting new patients
Seven Hills OB-GYN Associates, LLC CurrentSince Nov 18, 2023 Accepting new patients
Lima Memorial Joint Operating Company Past Accepting new patients

Locations

11405 Pennsylvania St
Ste 260
Carmel, IN 46032
Phone (317) 334-5718

10307 DuPont Circle Dr W
Ste A
Fort Wayne, IN 46825
Phone (260) 458-3240

10307 DuPont Circle Dr W
Ste B
Fort Wayne, IN 46825
Phone (260) 443-7420

Organizations & group practices 3

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": "1375920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1700006400000",
    "number": "1659703064",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3300 S FISKE BLVD",
            "city": "ROCKLEDGE",
            "state": "FL",
            "postal_code": "329554306",
            "telephone_number": "727-316-6210"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2043 LITTLE RD",
            "city": "TRINITY",
            "state": "FL",
            "postal_code": "346554421",
            "telephone_number": "727-846-7000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2439 Bee Ridge Rd",
            "address_purpose": "LOCATION",
            "city": "Sarasota",
            "state": "FL",
            "postal_code": "342396304",
            "country_code": "US",
            "telephone_number": "941-343-0609",
            "fax_number": "941-378-8190",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FENZL",
        "first_name": "TONYA",
        "middle_name": "S",
        "credential": "C.N.M.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-08-08",
        "last_updated": "2023-11-15",
        "certification_date": "2023-11-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": "FL",
            "license": "APRN9489996",
            "primary": false
        },
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": "OH",
            "license": "RN393909",
            "primary": false
        },
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": "IN",
            "license": "71014602A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE HF",
            "identifier": "OA244",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "115505700",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TONYA",
            "last_name": "BURROUGHS",
            "middle_name": "S",
            "credential": "C.N.M.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Trinity, FL

Sources for this page

Verify at the official NPI Registry.