Active NPI
Steven Palmer Fitzgerald, CRNA
- Anesthesiology Physician
- Ponca City, OK
National Provider Identifier
1679599690
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Anesthesiology Physician
- License
- R0033651
- Practice address
- 400 Fairview Ave Ste 50
Outpatient Surgical Center
Ponca City, OK 74601-1910 - Phone
- (580) 765-0673
- Fax
- (580) 765-0673
- NPI assigned
- Jul 14, 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 |
|---|---|---|---|---|
| Anesthesiology Physician | 207L00000X | R0033651 | OK | Primary |
Addresses
Primary practice location
400 Fairview Ave Ste 50
Outpatient Surgical Center
Ponca City, OK 74601-1910
Mailing address
PO Box 2538
Ponca City, OK 74602-2538
Phone (580) 765-0673
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 44442083003 | Other | OK | BCBS OKLAHOMA |
| P00287646 | Other | OK | RR MEDICARE |
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
- Credentials
- Certified Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| R0033651 | OK | MD | Anesthesiology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Outpatient Surgical Center of Ponca City, LLC | Past | Accepting new patients | |
| Outpatient Surgical Center of Ponca City, LLC | Past | Accepting new patients |
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.
-
- Ambulatory Surgical Clinic/Center
- Ponca City, OK
- NPI 1659337194
-
- Certified Registered Nurse Anesthetist
- Ponca City, OK
- NPI 1992905913
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1152835200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1193788800000",
"number": "1679599690",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 2538",
"city": "PONCA CITY",
"state": "OK",
"postal_code": "746022538",
"telephone_number": "580-765-0673",
"fax_number": "580-765-0673"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "400 FAIRVIEW AVE STE 50",
"address_2": "OUTPATIENT SURGICAL CENTER",
"city": "PONCA CITY",
"state": "OK",
"postal_code": "746011910",
"telephone_number": "580-765-0673",
"fax_number": "580-765-0673"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FITZGERALD",
"first_name": "STEVEN",
"middle_name": "PALMER",
"name_prefix": "Mr.",
"credential": "CRNA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-14",
"last_updated": "2007-10-31",
"status": "A"
},
"taxonomies": [
{
"code": "207L00000X",
"taxonomy_group": "",
"desc": "Anesthesiology",
"state": "OK",
"license": "R0033651",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS OKLAHOMA",
"identifier": "44442083003",
"state": "OK"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RR MEDICARE",
"identifier": "P00287646",
"state": "OK"
}
],
"endpoints": [],
"other_names": []
}Other providers in Ponca City, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.