Individual provider Active NPI

Donald Fill, CRNA

  • Certified Registered Nurse Anesthetist
  • Tampa, FL
National Provider Identifier
1942266077
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
ARNP 9230423 Issued in FL
Practice address
12902 Usf Magnolia Dr
Tampa, FL 33612-9416
Phone
(813) 745-8486
NPI assigned
Apr 26, 2006
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 3

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X ARNP 9230423 FL Primary
Certified Registered Nurse Anesthetist 367500000X RN 133357 AZ
Certified Registered Nurse Anesthetist 367500000X 4704172755 MI

Addresses

Primary practice location

12902 Usf Magnolia Dr
Tampa, FL 33612-9416

Mailing address

12738 Tar Flower Dr
Tampa, FL 33626-2340
Phone (248) 202-5913

Other identifiers 1

IdentifierTypeStateIssuer
G3925OtherFLBCBS

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

State licenses

LicenseStateTypeSpecialty
RN 133357AZMDCertified Registered Nurse Anesthetist
ARNP 9230423FLMDCertified Registered Nurse Anesthetist
4704172755MIMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Toledo Radiological Associates, Inc. Past Accepting new patients
Straith Hospital for Special Surgery Past Accepting new patients
Henry Ford Health Providence Hospital Nurse Anesthetist, Certified Registered Past Accepting new patients

Organizations & group practices 3

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": "1146009600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1942266077",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12738 TAR FLOWER DR",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336262340",
            "telephone_number": "248-202-5913"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12902 USF MAGNOLIA DR",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336129416",
            "telephone_number": "813-745-8486"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FILL",
        "first_name": "DONALD",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-26",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "FL",
            "license": "ARNP 9230423",
            "primary": true
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "AZ",
            "license": "RN 133357",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MI",
            "license": "4704172755",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "G3925",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tampa, FL

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.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.