Active NPI
Kelle Fecker, CRNA
- Certified Registered Nurse Anesthetist
- Wausau, WI
National Provider Identifier
1962444265
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Certified Registered Nurse Anesthetist
- License
- 145896030
- Practice address
- 425 Pine Ridge Blvd
Ste 211
Wausau, WI 54401 - Phone
- (715) 845-5505
- Fax
- (715) 848-2884
- NPI assigned
- Jun 12, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Certified Registered Nurse Anesthetist | 367500000X | 145896030 | WI | Primary |
Addresses
Primary practice location
425 Pine Ridge Blvd
Ste 211
Wausau, WI 54401
Mailing address
425 Pine Ridge Blvd
Ste 211
Wausau, WI 54401
Phone (715) 845-5505
Other identifiers 8
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 88792 | Other | WI | SECURITY HEALTH PLAN |
| SWOPE | Other | WI | WPS |
| 44326600 | Other | WI | MANAGED HEALTH CARE |
| 391330887 | Other | WI | ASSOCIATES FOR HEALTHCARE |
| 003921305 | Other | WI | HUMAN GOLD MEDICARE |
| 44326600 | Medicaid | WI | |
| P00088510 | Other | WI | MEDICARE RAILROAD |
| 88792 | Other | WI | SECURITY HEALTH MEDICAID |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WI
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Certified Registered Nurse Anesthetist (Crna)
- Education
- Georgetown University School of Medicine, 2001
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
425 Pine Ridge Blvd
Suite 211
Wausau, WI 54401-4123
Phone (715) 845-5505
Hospital & facility affiliations
- Aspirus Wausau Hospital
Merit-based Incentive Payment System (MIPS)
- Final score
- 79.11 of 100
- Quality
- 74.74
- Improvement activities
- 40
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Certified Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 145896030 | WI | MD | Certified Registered Nurse Anesthetist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Central Wisconsin Anesthesiology | Current | Accepting new patients |
Locations
425 Pine Ridge Blvd
Ste 211
Wausau, WI 54401
Phone (715) 845-5505
Organizations & group practices 1
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.
-
- Anesthesiology Physician
- Wausau, WI
- NPI 1518999648
Hospital & facility affiliations 10
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Wausau, WI
- NPI 1558363986
-
- General Acute Care Hospital
- Stevens Point, WI
- NPI 1598375271
-
- General Acute Care Hospital
- Wausau, WI
- NPI 1902923170
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1150070400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1287705600000",
"number": "1962444265",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "425 PINE RIDGE BLVD",
"address_2": "STE 211",
"city": "WAUSAU",
"state": "WI",
"postal_code": "54401",
"telephone_number": "715-845-5505",
"fax_number": "715-848-2884"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "425 PINE RIDGE BLVD",
"address_2": "STE 211",
"city": "WAUSAU",
"state": "WI",
"postal_code": "54401",
"telephone_number": "715-845-5505",
"fax_number": "715-848-2884"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FECKER",
"first_name": "KELLE",
"name_prefix": "Ms.",
"credential": "CRNA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-06-12",
"last_updated": "2010-10-22",
"status": "A"
},
"taxonomies": [
{
"code": "367500000X",
"taxonomy_group": "",
"desc": "Nurse Anesthetist, Certified Registered",
"state": "WI",
"license": "145896030",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "SECURITY HEALTH PLAN",
"identifier": "88792",
"state": "WI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "WPS",
"identifier": "SWOPE",
"state": "WI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MANAGED HEALTH CARE",
"identifier": "44326600",
"state": "WI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ASSOCIATES FOR HEALTHCARE",
"identifier": "391330887",
"state": "WI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HUMAN GOLD MEDICARE",
"identifier": "003921305",
"state": "WI"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "44326600",
"state": "WI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE RAILROAD",
"identifier": "P00088510",
"state": "WI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "SECURITY HEALTH MEDICAID",
"identifier": "88792",
"state": "WI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Wausau, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2010; 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.