Jackie Fane, M.D.

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

MT211533 Issued in FL

Practice address

230 N Broad St
Philadelphia, PA 19102-1121

Phone

(215) 762-2618

NPI assigned

Jun 6, 2016

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TN, NC2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 2

Specialty

Emergency Medicine

Education

University of Florida College of Medicine, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Tennessee River Physicians, PLLCGroup PAC ID 8022387349, 65 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Erlanger Medical Center Hospital, Chattanooga, TN, CCN 440104

Merit-based Incentive Payment System (MIPS)

Final score

100 of 100Reported as group

Promoting interoperability

100

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/14272/brand/70/csg/1/fhir/r4

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.

• Tennessee River Physicians, PLLC

  • Emergency Medicine Physician
  • Chattanooga, TN
  • NPI 1396282463
  Medicare reassignment Care Compare group NPD
• Murphy Emergency Physicians, PLLC

  • Emergency Medicine Physician
  • Murphy, NC
  • NPI 1053808378
  Medicare reassignment NPD
• Spring Creek Emergency Physicians PLLC

  • Emergency Medicine Physician
  • Chattanooga, TN
  • NPI 1275961799
  NPD
• Tennessee River Physicians, PLLC

  • Emergency Medicine Physician
  • Dunlap, TN
  • NPI 1699212761
  NPD
• Tennessee River Physicians, PLLC

  • Emergency Medicine Physician
  • Chattanooga, TN
  • NPI 1710424882
  NPD
• Parkridge Medical Center, Inc.

  • General Acute Care Hospital
  • Chattanooga, TN
  • NPI 1104874684
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Erlanger Health

  • General Acute Care Hospital
  • Chattanooga, TN
  • NPI 1861194086
  Care Compare affiliation

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

{
    "created_epoch": "1465171200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1465171200000",
    "number": "1760831333",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "230 N BROAD ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191021121"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "230 N BROAD ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191021121",
            "telephone_number": "215-762-2618"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FANE",
        "first_name": "JACKIE",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-06-06",
        "last_updated": "2016-06-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "FL",
            "license": "MT211533",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Terrence T. Fan, D.M.D
• Wen-Lin Fan, MD
• Xin Fan
• Faramarz Fanaian, DPM
• Alexander C Fanaroff, M.D., M.H.S.
• Kathleen Elissa Fane, M.D.
• Jeffrey Faneck, PHARMD
• Andrea Fanelli, NP
• Elaine Fanelli, CRNP
• Nicole Renee Fanelli, CRNA

• Emergency Medicine Physician in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• Emergency Medicine Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 6, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.