Individual provider Active NPI

Robert Fechtenburg, CRNA

  • Certified Registered Nurse Anesthetist
  • Deland, FL
National Provider Identifier
1871519652
Registry record updated Feb 15, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
ARNP2766212 Issued in FL
Practice address
701 W Plymouth Ave
Deland, FL 32720-3236
Phone
(407) 667-0444
Fax
(407) 667-4338
NPI assigned
Jul 14, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 15, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X ARNP2766212 FL Primary

Addresses

Primary practice location

701 W Plymouth Ave
Deland, FL 32720-3236

Mailing address

291 Southhall LN
Suite 201
Maitland, FL 32751-7274
Phone (407) 667-0444

Other identifiers 2

IdentifierTypeStateIssuer
034951800MedicaidFL
G1712OtherFLBCBS

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

LicenseStateTypeSpecialty
ARNP2766212FLMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Baycare Anesthesia Associates LLC Past Accepting new patients
Collier Anesthesia PA Past Accepting new patients
Sarasota Anesthesiologists, PA PastSince Jan 26, 2004 Accepting new patients
Brevard Eye Center PastSince Oct 1, 1992 Accepting new patients
Lake County Anesthesia Associates PA Nurse Anesthetist, Certified Registered Past Accepting new patients
Tri-County Anesthesia Volusia Nurse Anesthetist, Certified Registered Past Accepting new patients
Medical Anesthesia and Pain Management Consultants, P.a. PastSince May 1, 2015 Accepting new patients
Jennifer Sassi PA Nurse Anesthetist, Certified Registered PastSince Feb 5, 2014 Accepting new patients

Networks

  • Freedom Health HMO Network

Organizations & group practices 8

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.

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": "1203033600000",
    "number": "1871519652",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "291 SOUTHHALL LN",
            "address_2": "SUITE 201",
            "city": "MAITLAND",
            "state": "FL",
            "postal_code": "327517274",
            "telephone_number": "407-667-0444",
            "fax_number": "407-667-4338"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "701 W PLYMOUTH AVE",
            "city": "DELAND",
            "state": "FL",
            "postal_code": "327203236",
            "telephone_number": "407-667-0444",
            "fax_number": "407-667-4338"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FECHTENBURG",
        "first_name": "ROBERT",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-14",
        "last_updated": "2008-02-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "FL",
            "license": "ARNP2766212",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "034951800",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "G1712",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Deland, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 15, 2008; 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.