MARY L FETTERMAN – Certified Registered Nurse Anesthetist, NPI 1073649943

MARY L FETTERMAN is a healthcare provider. based in Augusta, Georgia. specializing in CERTIFIED REGISTERED NURSE ANESTHETIST (CRNA). They hold a License No. RN047278 (GA). The NPI Number for MARY L FETTERMAN is 1073649943

Main info

Female
50 Years Of Experience
Accepts Medicare Assignment
Name
MARY L FETTERMAN
NPI
1073649943
Phone
(800) 394-4445
Address
804 SCOTT NIXON MEMORIAL DR
Enumeration Date
26 February 2007
Last Update Date
11 February 2008

Doctor Profile

Medical School Name
OTHER
Secondary Phone
6785141991
Graduation Year
1976 (50 years ago)
PAC ID
8325128838
Group Practice PAC ID
7618934779
Professional Enrollment ID
I20080109000246
Address ID
GA300335918DE2701XRDXX400
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience52
Completeness75
Years active:19State licenses:1Digital endpointsOther names

1,710 CERTIFIED REGISTERED NURSE ANESTHETIST (CRNA) in GA

Provider Addresses for MARY L FETTERMAN

  • 804 SCOTT NIXON MEMORIAL DR

    AUGUSTA, GA 309072464

    Phone: (800) 394-4445

    Type: Mailing

  • 6605 ABERCORN ST

    ST 108

    SAVANNAH, GA 314055815

    Phone: (912) 354-5357

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2008-01-09

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20080109000246ICertified Registered Nurse Anesthetist (Crna)GATBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 30907)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 7618934779View full group profile
NameSpecialtyState
Anesthesiology AssistantGA
Certified Registered Nurse Anesthetist (Crna)GA
Anesthesiology AssistantGA
Certified Registered Nurse Anesthetist (Crna)FL
Pain Management, Anesthesiology, Interventional Pain ManagementGA
-TX
-KY
-SC
Anesthesiology AssistantGA
Certified Registered Nurse Anesthetist (Crna)TX

Reviews

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Frequently asked questions

What federal number belongs to MARY L FETTERMAN?
The federal identifier for MARY L FETTERMAN is NPI 1073649943.
Is MARY L FETTERMAN currently active in the NPI registry?
CMS-published data lists MARY L FETTERMAN as an active registrant.
What field does MARY L FETTERMAN work in?
You can think of MARY L FETTERMAN as practicing within Certified Registered Nurse Anesthetist. Clinical services aligned with this taxonomy classification.
Where is MARY L FETTERMAN's primary listing?
We display Augusta, Georgia because that is what the record indicates for MARY L FETTERMAN.
What if Augusta, Georgia seems incomplete?
Street-level detail can be omitted — open the full address list for this NPI.

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