Blayne Elizabeth Fenner, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

BP10088147 Issued in TX

Practice address

1501 Red River St FL 2
Austin, TX 78712-1845

Phone

(512) 495-5555

NPI assigned

May 4, 2024

Sex

Female

Sole proprietor

No

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1714780800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714780800000",
    "number": "1821845017",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1501 RED RIVER ST FL 2",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787121845"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1501 RED RIVER ST FL 2",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787121845",
            "telephone_number": "512-495-5555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FENNER",
        "first_name": "BLAYNE",
        "middle_name": "ELIZABETH",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-05-04",
        "last_updated": "2024-05-04",
        "certification_date": "2024-05-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "BP10088147",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kylie Christine Felty, RD, LD
• Laurence Edward Fendrich, D.M.D.
• Jinzhi Feng
• Malka Fenig, LPC
• Douglas Edward-Maxwell Fenley, OTR
• John Clare Fenner, M.S.S.W.
• Lief Ericsson Fenno, M.D.
• Arnold L Fenrich Jr., MD
• Rachel Kay Fenske
• Amber Sturges Fenton, MD

• All providers in Austin, TX
• Internal Medicine Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 4, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.