Kimberly Phillips Fortenberry, in Covington, LA - Medicare Certified Registered Nurse Anesthetist (crna)

Kimberly Phillips Fortenberry, is a medicare enrolled "Nurse Anesthetist, Certified Registered" in Covington, Louisiana. She graduated from nursing school in 2000 and has 24 years of diverse experience with area of expertise as Certified Registered Nurse Anesthetist (crna). She is a member of the group practice Etas Pllc and her current practice location is 1202 S Tyler St, Covington, Louisiana. You can reach out to her office (for appointments etc.) via phone at (985) 898-4000.

Kimberly Phillips Fortenberry is licensed to practice in Louisiana (license number RN072659) and she also participates in the medicare program. She accepts medicare assignments (which means she accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and her NPI Number is 1750345005.

Contact Information

	Kimberly Phillips Fortenberry,
	1202 S Tyler St, Covington, LA 70433-2330
	(985) 898-4000
	(985) 898-4394

Map and Direction

Provider's Profile

Full Name	Kimberly Phillips Fortenberry
Gender	Female
Speciality	Certified Registered Nurse Anesthetist (crna)
Experience	24 Years
Location	1202 S Tyler St, Covington, Louisiana
Accepts Medicare Assignments	Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance.

Medical Education and Training:

Kimberly Phillips Fortenberry graduated from nursing school in 2000

NPI Data:

NPI Number: 1750345005
Provider Enumeration Date: 04/13/2006
Last Update Date: 11/03/2023

Medicare PECOS Information:

PECOS PAC ID: 8022030162
Enrollment ID: I20180410001577

Medical Identifiers

Medical identifiers for Kimberly Phillips Fortenberry such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1750345005	NPI	-	NPPES
1569755	Medicaid	LA
430057274	Other		RR MEDICARE NUMBER

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
367500000X	Nurse Anesthetist, Certified Registered	901488 (Mississippi)	Secondary
367500000X	Nurse Anesthetist, Certified Registered	RN072659 (Louisiana)	Primary

Medical Facilities Affiliation

Facility Name	Location	Facility Type
Memorial Hospital At Gulfport	Gulfport, MS	Hospital

Group Practice Association

Group Practice Name	Group PECOS PAC ID	No. of Members
Etas Pllc	8123481934	44

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Kimberly Phillips Fortenberry allows following entities to bill medicare on her behalf.

Entity Name	Hattiesburg Clinic Pa
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1740213446 PECOS PAC ID: 5193706794 Enrollment ID: O20040528000685

Entity Name	Etas Pllc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1679259360 PECOS PAC ID: 8123481934 Enrollment ID: O20230828000521

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Kimberly Phillips Fortenberry is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing Address	Practice Location Address
Kimberly Phillips Fortenberry, 120 Innwood Dr, Covington, Covington, LA 70433-9123 Ph: (985) 892-3225	Kimberly Phillips Fortenberry, 1202 S Tyler St, Covington, LA 70433-2330 Ph: (985) 898-4000

Reviews and Comments

Nurse Anesthetist, Certified Registered Nurses in Covington, LA

Kaleb Killens, CRNA Nurse Anesthetist - CR Medicare: Medicare Enrolled Practice Location: 67252 Industry Ln, Covington, LA 70433 Phone: 985-809-9888
Regina Bourgeois, CRNA Nurse Anesthetist - CR Medicare: Not Enrolled in Medicare Practice Location: 1202 S Tyler St, Covington, LA 70433 Phone: 985-898-4000
Christina Pollet, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 1202 S Tyler St, Covington, LA 70433 Phone: 985-898-4000
Esteban R Zorrilla, CRNA Nurse Anesthetist - CR Medicare: Not Enrolled in Medicare Practice Location: 1202 S Tyler St, Covington, LA 70433 Phone: 985-898-4000
Jason E Bernard, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 1202 S Tyler St, Covington, LA 70433 Phone: 985-898-4000
David M Burdett, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 1202 Styler St, Covington, LA 70433 Phone: 985-898-4000
Joshua Fay, Nurse Anesthetist - CR Medicare: May Accept Medicare Assignments Practice Location: 95 Judge Tanner Blvd, Covington, LA 70433 Phone: 540-761-7371

Kimberly Phillips Fortenberry, - Medicare Certified Registered Nurse Anesthetist (crna) in Covington, LA