Organization Active NPI

Frederick S Utter MHS Crna PC

  • Certified Registered Nurse Anesthetist
  • El Paso, TX
National Provider Identifier
1700189925
Registry record updated Dec 16, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
Legal business name
FREDERICK S UTTER MHS CRNA PC
Practice address
1900 Denver Ave
El Paso, TX 79902-3008
Phone
(915) 407-6035
NPI assigned
Dec 9, 2010
Last updated
Dec 16, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 16, 2022

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

Authorized official

Name
Frederick Stuart Utter, CRNANPI 1306845508
Title
Owner
Phone
(915) 494-8779

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X NU Primary

Addresses

Primary practice location

1900 Denver Ave
El Paso, TX 79902-3008

Mailing address

9895 Alameda Ave Ste 108
Socorro, TX 79927-2976
Phone (915) 772-4551

Other identifiers 2

IdentifierTypeStateIssuer
283576101MedicaidTX
78621348MedicaidNM

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX, NM2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20110623000471 TX Part B Supplier - Clinic/Group Practice 6002094992 Receives reassigned benefits from 1 practitioner
Practice locations: El Paso, TX
O20190131000136 NM Part B Supplier - Clinic/Group Practice 6002094992 Receives reassigned benefits from 2 practitioners
Practice locations: Alamogordo, NM

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1291852800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1671148800000",
    "number": "1700189925",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9895 ALAMEDA AVE STE 108",
            "city": "SOCORRO",
            "state": "TX",
            "postal_code": "799272976",
            "telephone_number": "915-772-4551",
            "fax_number": "915-232-9920"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1900 DENVER AVE",
            "city": "EL PASO",
            "state": "TX",
            "postal_code": "799023008",
            "telephone_number": "915-407-6035"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FREDERICK S UTTER MHS CRNA PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-12-09",
        "last_updated": "2022-12-16",
        "certification_date": "2022-12-16",
        "status": "A",
        "authorized_official_last_name": "UTTER",
        "authorized_official_first_name": "FREDERICK",
        "authorized_official_middle_name": "STUART",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "915-494-8779",
        "authorized_official_credential": "CRNA"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "283576101",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "78621348",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in El Paso, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.