Active NPI
Sherry A. Fetzer, F.N.P.
- Nurse Practitioner
- Knoxville, TN
National Provider Identifier
1972533651
On this page
OIG exclusion record
The HHS Office of Inspector General’s List of Excluded Individuals/Entities (LEIE) contains a record with this NPI:
- Section 1128a(4) exclusion effective Jul 20, 2017.
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- RN0133346
- Practice address
- 1924 Alcoa Hwy
Knoxville, TN 37920-1511 - Phone
- (865) 544-9000
- NPI assigned
- Jul 5, 2006
- Last updated
- Nov 7, 2007
- 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 |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | RN0133346 | TN | Primary |
Addresses
Primary practice location
1924 Alcoa Hwy
Knoxville, TN 37920-1511
Mailing address
PO Box 634760
Cincinnati, OH 45263-0001
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 4065946 | Other | TN | BLUE CROSS |
| P00325037 | Other | TN | RAILROAD MEDICARE |
| 78011921 | Medicaid | KY |
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)
- Not enrolled
- HHS exclusion list flag
- Flagged The directory lists this NPI on an HHS exclusion list.
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RN0133346 | TN | MD | Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Southeastern Emergency Services P C | Nurse Practitioner | Past | Accepting new patients |
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Nurse Practitioner
- Athens, TN
- NPI 1669414264
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1152057600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1194393600000",
"number": "1972533651",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 634760",
"city": "CINCINNATI",
"state": "OH",
"postal_code": "452630001"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1924 ALCOA HWY",
"city": "KNOXVILLE",
"state": "TN",
"postal_code": "379201511",
"telephone_number": "865-544-9000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FETZER",
"first_name": "SHERRY",
"middle_name": "A.",
"name_prefix": "Ms.",
"credential": "F.N.P.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-07-05",
"last_updated": "2007-11-07",
"status": "A"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "TN",
"license": "RN0133346",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS",
"identifier": "4065946",
"state": "TN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "P00325037",
"state": "TN"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "78011921",
"state": "KY"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Knoxville, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; OIG LEIE.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.