Active NPI
Brian Fenn, CRNA
- Certified Registered Nurse Anesthetist
- Plymouth, MA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Certified Registered Nurse Anesthetist
- License
- RN174475
- Practice address
- 275 Sandwich St
Plymouth, MA 02360 - Phone
- (508) 746-2000
- NPI assigned
- Dec 5, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Certified Registered Nurse Anesthetist | 367500000X | RN174475 | MA | Primary |
| Certified Registered Nurse Anesthetist | 367500000X | 062441-23 | NH |
Addresses
Primary practice location
275 Sandwich St
Plymouth, MA 02360
Mailing address
275 Sandwich St
Plymouth, MA 02360-2183
Phone (508) 746-2000
Other practice location 1
One Medical Village Drive
Independent Anesthesiologists PSC
Edgewood, KY 41017
Phone (859) 341-7246
Other practice location 2
One Medical Village Drive
Independent Anesthesiologists PSC
Edgewood, KY 41017
Phone (859) 341-7246
Other practice location 3
789 Central Ave
Dover, NH 03820-2526
Phone (603) 609-6819
Other identifiers 5
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0810500 | Medicaid | OH | |
| 3134668 | Medicaid | NH | |
| 74382060 | Medicaid | KY | |
| 000000179713 | Other | ANTHEM BLUE SHIELD | |
| 200419580 | Medicaid | IN |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MA, NH
Enrollment records 2
Care Compare profile
Medicare Care Compare- Specialty
- Certified Registered Nurse Anesthetist (Crna)
- Education
- Other, 1985
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
41 Highland Ave
Winchester, MA 01890-1446
Phone (781) 756-2190
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Certified Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4258 | CT | MD | General Practice Dentistry |
| 062441-23 | NH | MD | Certified Registered Nurse Anesthetist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Associated Physicians of Harvard Medical Faculty Physicians at Beth Is | Current | Accepting new patients | |
| Barrington Surgical Care LLC | Current | Accepting new patients | |
| Winchester Anesthesia Associates, Inc | Current | Accepting new patients | |
| Associated Physicians of Harvard Medical Faculty Physicians at Beth Is | Current | Accepting new patients | |
| Icon Anesthesia Services of New England LLC | Current | Accepting new patients | |
| Associated Physicians of Harvard Medical Faculty Physicians at Beth Is | Current | Accepting new patients | |
| Rye Surgical Center, LLC | Current | Accepting new patients | |
| Northeast Medical Consultants PC | Current | Accepting new patients | |
| Winchester Anesthesia Associates 2 Inc | Current | Accepting new patients | |
| Waterbury Anesthesiology Assoc. Inc | Past | Accepting new patients | |
| Western Ohio Anesthesia Associates | Past | Accepting new patients |
Locations
25 Highland Ave
Newburyport, MA 01950
Phone (978) 258-4734
275 Sandwich St
Plymouth, MA 02360
Phone (508) 746-2000
41 Highland Ave
Winchester, MA 01890
Phone (781) 756-2000
944 Calef Hwy
Barrington, NH 03825
Phone 6036640100118
2 Pillsbury St
Ste 100
Concord, NH 03301
Phone (603) 224-2020
31 Main St
Plaistow, NH 03865
Phone (603) 382-4741
270 Lafayette Rd
Rye, NH 03870
Phone (603) 319-1581
Organizations & group practices 11
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.
-
- Pain Medicine (Anesthesiology) Physician
- Winchester, MA
- NPI 1972626117
-
- Diagnostic Radiology Physician
- Milton, MA
- NPI 1245773308
-
- Anesthesiology Physician
- Middleton, MA
- NPI 1629583323
NH
-
- Anesthesiology Physician
- Winchester, MA
- NPI 1427599588
-
- Ambulatory Surgical Clinic/Center
- Barrington, NH
- NPI 1801994553
-
- Interventional Pain Medicine Physician
- Barrington, NH
- NPI 1215946181
-
- Ambulatory Surgical Clinic/Center
- Rye, NH
- NPI 1336562156
-
- Anesthesiology Physician
- Plymouth, MA
- NPI 1568859643
-
- Multi-Specialty Clinic/Center
- Boston, MA
- NPI 1861216038
-
- Anesthesiology Physician
- Waterbury, CT
- NPI 1780631960
-
- Pain Medicine (Anesthesiology) Physician
- Oxford, OH
- NPI 1083607568
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1133740800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1672790400000",
"number": "1891779732",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "275 SANDWICH ST",
"city": "PLYMOUTH",
"state": "MA",
"postal_code": "023602183",
"telephone_number": "508-746-2000"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "275 SANDWICH ST",
"city": "PLYMOUTH",
"state": "MA",
"postal_code": "02360",
"telephone_number": "508-746-2000"
}
],
"practiceLocations": [
{
"address_1": "One Medical Village Drive",
"address_2": "Independent Anesthesiologists PSC",
"address_purpose": "LOCATION",
"city": "Edgewood",
"state": "KY",
"postal_code": "41017",
"country_code": "US",
"telephone_number": "859-341-7246",
"fax_number": "859-341-7867",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "One Medical Village Drive",
"address_2": "Independent Anesthesiologists PSC",
"address_purpose": "LOCATION",
"city": "Edgewood",
"state": "KY",
"postal_code": "41017",
"country_code": "US",
"telephone_number": "859-341-7246",
"fax_number": "859-341-7867",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "789 Central Ave",
"address_purpose": "LOCATION",
"city": "Dover",
"state": "NH",
"postal_code": "038202526",
"country_code": "US",
"telephone_number": "603-609-6819",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "FENN",
"first_name": "BRIAN",
"credential": "CRNA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-12-05",
"last_updated": "2023-01-04",
"certification_date": "2023-01-04",
"status": "A"
},
"taxonomies": [
{
"code": "367500000X",
"taxonomy_group": "",
"desc": "Nurse Anesthetist, Certified Registered",
"state": "MA",
"license": "RN174475",
"primary": true
},
{
"code": "367500000X",
"taxonomy_group": "",
"desc": "Nurse Anesthetist, Certified Registered",
"state": "NH",
"license": "062441-23",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0810500",
"state": "OH"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "3134668",
"state": "NH"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "74382060",
"state": "KY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ANTHEM BLUE SHIELD",
"identifier": "000000179713",
"state": null
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "200419580",
"state": "IN"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Plymouth, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- 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.