NPIMap

Individual provider Active NPI

Charles J Fetner, CRNA

  • Certified Registered Nurse Anesthetist
  • Colquitt, GA
National Provider Identifier
1902975675
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
RN063272 Issued in GA
Practice address
209 N Cuthbert St
Colquitt, GA 39837-3518
Phone
(229) 758-6062
NPI assigned
Nov 7, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 RN063272 GA Primary

Addresses

Primary practice location

209 N Cuthbert St
Colquitt, GA 39837-3518

Mailing address

2066 Three Notch Rd
Blakely, GA 39823-3015
Phone (229) 758-6062

Other identifiers 1

IdentifierTypeStateIssuer
00546851CMedicaidGA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041202000271 GA Practitioner - Certified Registered Nurse Anesthetist (Crna) 3971569955 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

209 N Cuthbert St
Colquitt, GA 39837-3518
Phone (229) 758-4212

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
87.45 of 100Reported as group
Quality
76.8
Promoting interoperability
100
Improvement activities
40
Cost
48.02

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
The Hospital Authority of Miller County CurrentSince Jul 30, 2023 Accepting new patients
Nmda Anesthesia LLC Nurse Anesthetist, Certified Registered CurrentSince Jan 1, 2012 Accepting new patients
The Hospital Authority of Miller County Current Accepting new patients
Sweet Dreams Anesthesiology Nurses of Georgia LLC Nurse Anesthetist, Certified Registered CurrentSince Jun 30, 2013 Accepting new patients
The Hospital Authority of Miller County Current Accepting new patients
Sweet Dreams Nurse Anesthesiology LLC Nurse Anesthetist, Certified Registered CurrentSince Jul 15, 2011 Accepting new patients
Synergy Anesthesiology Inc Nurse Anesthetist, Certified Registered Past Accepting new patients
Sweet Dreams Nurse Anesthesia, Inc. Nurse Anesthetist, Certified Registered Past Accepting new patients
Sweet Dreams of Albany LLC Nurse Anesthetist, Certified Registered Past Accepting new patients

Locations

619 Pointe North Blvd
Albany, GA 31721
Phone (229) 883-4707

158 Clinic Ave
Carrollton, GA 30117
Phone (770) 834-1008

208 N Cuthbert St
Colquitt, GA 39837
Phone (229) 758-3304

209 N Cuthbert St
Colquitt, GA 39837
Phone (229) 758-3385

110 Professional Ct
Jesup, GA 31545
Phone (830) 714-3073

2 Hospital Park
Moultrie, GA 31768
Phone (229) 391-4130

1035 Southcrest Dr
Ste 250
Stockbridge, GA 30281
Phone (770) 996-9945

Organizations & group practices 10

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.

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1162857600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1902975675",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2066 THREE NOTCH RD",
            "city": "BLAKELY",
            "state": "GA",
            "postal_code": "398233015",
            "telephone_number": "229-758-6062"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "209 N CUTHBERT ST",
            "city": "COLQUITT",
            "state": "GA",
            "postal_code": "398373518",
            "telephone_number": "229-758-6062"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FETNER",
        "first_name": "CHARLES",
        "middle_name": "J",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-07",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "GA",
            "license": "RN063272",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00546851C",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Colquitt, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.

Verify at the official NPI Registry.