Bethany Ann Fetzer, FNP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

AP10074 Issued in AZ

Practice address

4121 E Valley Auto Dr Ste 110
Mesa, AZ 85206-4632

Phone

(480) 892-1122

NPI assigned

May 4, 2017

Last updated

May 4, 2017By the provider in NPPES

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

Enrolled in AZ

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Community Bridges IncGroup PAC ID 2062699721, 106 clinicians

Little Colorado Behavioral Health Center Inc.Group PAC ID 4587657465, 4 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

Credentials

Nurse Practitioner

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: bethany.fetzernp.p1@direct.cbridges.nextgenshare.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Community Bridges, Inc.

  dba CBI - Encompass Page Integrated Health Home

  • Adult Mental Health Clinic/Center
  • Page, AZ
  • NPI 1558095315
  Medicare reassignment Care Compare group NPD
• Little Colorado Behavioral Health Center Inc.

  • Community/Behavioral Health Agency
  • Saint Johns, AZ
  • NPI 1134292485
  Medicare reassignment Care Compare group NPD
• Transitions Center PLLC

  • Psychiatry Physician
  • Tempe, AZ
  • NPI 1821485954
  Medicare reassignment NPD
• Community Bridges, Inc

  dba Lighthouse

  • Mental Illness Community Based Residential Treatment Facility
  • Yuma, AZ
  • NPI 1861722175
  NPD
• Community Bridges, Inc.

  dba Benson Transition Point

  • Mental Illness Community Based Residential Treatment Facility
  • Benson, AZ
  • NPI 1255900189
  NPD
• Community Bridges, Inc.

  dba Toole Outpatient Service Center

  • Community/Behavioral Health Agency
  • Tucson, AZ
  • NPI 1427596196
  NPD
• Community Bridges, Inc.

  dba Community Psychiatric Emergency Center - Outpatient

  • Community/Behavioral Health Agency
  • Mesa, AZ
  • NPI 1588348775
  NPD
• Little Colorado Behavioral Health Center Inc.

  dba SMI Supportive Housing - Apache

  • Community/Behavioral Health Agency
  • Saint Johns, AZ
  • NPI 1588543029
  NPD
• Little Colorado Behavioral Health Center Inc.

  • Community/Behavioral Health Agency
  • Springerville, AZ
  • NPI 1194872085
  NPD (past)
• Psychiatric Associates, PLLC

  • Child & Adolescent Psychiatry Physician
  • Tempe, AZ
  • NPI 1699681718
  NPD (past)

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

{
    "created_epoch": "1493856000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1493856000000",
    "number": "1902332315",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4121 E VALLEY AUTO DRIVE # 110",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "85206",
            "telephone_number": "480-892-1122"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4121 E VALLEY AUTO DR STE 110",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852064632",
            "telephone_number": "480-892-1122"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FETZER",
        "first_name": "BETHANY",
        "middle_name": "ANN",
        "name_prefix": "Mrs.",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-05-04",
        "last_updated": "2017-05-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AZ",
            "license": "AP10074",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lucia F. Ferreras-Cox, M.D.
• Rebecca Ferrin, LAC
• Nicole Lynn Ferschke, PA
• Fervent Care Services LLC
• Lauren Nicole Fettis, BCBA
• Elizabeth Feweks
• Madeline Feyrer-Melk, DO
• Lora Elizabeth Fiala, CPM, LM
• Debbie Fickle, CO
• Michael Dale Fidler, EDD

• Family Nurse Practitioner in Mesa, AZ
• Providers in Mesa, AZ by specialty
• Family Nurse Practitioner in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 4, 2017; 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.