Randy S Fatheree, DO

Primary specialty

Anesthesiology PhysicianTaxonomy code 207L00000X

License

108473 Issued in MO

Practice address

10 Hospital Dr
Saint Peters, MO 63376-1659

Phone

(314) 895-3828

Fax

(314) 895-3827

NPI assigned

Oct 3, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in IL

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 1

Specialty

Anesthesiology

Education

At Still University of Health Sciences, College of Osteo Med, Kirksville, 1995

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Jacksonville Crnas IncGroup PAC ID 2961681523, 17 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Jacksonville Memorial Hospital Hospital, Jacksonville, IL, CCN 141352

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

Practice roles

Locations

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.

• Jacksonville Crnas Inc

  • Certified Registered Nurse Anesthetist
  • Jacksonville, IL
  • NPI 1821302068

  Anesthesiology

  Medicare reassignment Care Compare group NPD

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

• Passavant Memorial Area Hospital Association

  dba Passavant Area Hospital

  • Critical Access Hospital
  • Jacksonville, IL
  • NPI 1174580831
  Care Compare affiliation

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

{
    "created_epoch": "1128297600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1269734400000",
    "number": "1780671065",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5",
            "city": "HAZELWOOD",
            "state": "MO",
            "postal_code": "630420005",
            "telephone_number": "314-895-3828",
            "fax_number": "314-895-3827"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 HOSPITAL DR",
            "city": "SAINT PETERS",
            "state": "MO",
            "postal_code": "633761659",
            "telephone_number": "314-895-3828",
            "fax_number": "314-895-3827"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FATHEREE",
        "first_name": "RANDY",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-03",
        "last_updated": "2010-03-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "MO",
            "license": "108473",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "244631008",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Family Dental Services LTD
• Family Faith & Friends Home Health Care and Hospice Agency
• Nikko Farmer, RN
• James Timothy Farrell, D.O.
• Kristen Marie Farris, PA
• Feet First Podiatry LLC
• Ellen Barron Feldman, RN MA LPC
• Ronald Feldman
• Jomarie Feliciano Torres, DC
• Kristy Lynn Ferguson, MPT

• Anesthesiology Physician in Saint Peters, MO
• Providers in Saint Peters, MO by specialty
• Anesthesiology Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 2010; 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.