| Jordan Martha Lee Fenner, | |
|
101 Manning Dr, Chapel Hill, NC 27514-4220 | |
| (984) 974-1000 | |
| Not Available |
| Full Name | Jordan Martha Lee Fenner |
|---|---|
| Gender | Female |
| Speciality | Diagnostic Radiology |
| Experience | 8 Years |
| Location | 101 Manning Dr, Chapel Hill, North Carolina |
| Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1356831622 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2085R0202X | Radiology - Diagnostic Radiology | 2020-03182 (North Carolina) | Secondary |
| 2085R0202X | Radiology - Diagnostic Radiology | 84156 (Wisconsin) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| University Of Wi Hospitals & Clinics Authority | Madison, WI | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Group Health Cooperative Of South Central Wisconsin | 3870489586 | 199 |
| University Of Wisconsin Medical Foundation Inc | 6608785464 | 2380 |
| Entity Name | University Of Wisconsin Medical Foundation Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1598784555 PECOS PAC ID: 6608785464 Enrollment ID: O20031111000435 |
| Entity Name | University Of Wisconsin System Non Payroll |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1346266319 PECOS PAC ID: 9133024888 Enrollment ID: O20031204001102 |
| Entity Name | Group Health Cooperative Of South Central Wisconsin |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1245260165 PECOS PAC ID: 3870489586 Enrollment ID: O20040227000306 |
| Mailing Address | Practice Location Address |
|---|---|
| Jordan Martha Lee Fenner, 4833 Crystal Downs Way, Middleton, WI 53597-8960 Ph: (630) 400-7662 | Jordan Martha Lee Fenner, 101 Manning Dr, Chapel Hill, NC 27514-4220 Ph: (984) 974-1000 |
Dr. Romuald Ferre, Radiology Medicare: Accepting Medicare Assignments Practice Location: 101 Manning Dr, Chapel Hill, NC 27514 Phone: 984-974-1884 | |
Joseph Kt Lee, MD Radiology Medicare: Not Enrolled in Medicare Practice Location: 101 Manning Dr, Chapel Hill, NC 27599 Phone: 919-966-4131 | |
Dr. Dorothy Amy Sippo, M.D. Radiology Medicare: Accepting Medicare Assignments Practice Location: 101 Manning Dr, Chapel Hill, NC 27514 Phone: 984-974-1884 | |
Dr. Maureen Pearl Kohi, M.D. Radiology Medicare: Accepting Medicare Assignments Practice Location: 101 Manning Dr, Chapel Hill, NC 27514 Phone: 984-974-1000 | |
Matthew Mauro, MD Radiology Medicare: Accepting Medicare Assignments Practice Location: 101 Manning Dr, Chapel Hill, NC 27599 Phone: 919-966-8596 Fax: 919-843-5515 | |
Dr. Ron Aaron Perets, MD Radiology Medicare: Medicare Enrolled Practice Location: 101 Manning Drive, 4061 Burnett-womack Bldg, Chapel Hill, NC 27514 Phone: 919-966-4653 | |
Kenneth Lury, MD Radiology Medicare: Not Enrolled in Medicare Practice Location: 101 Manning Dr, Chapel Hill, NC 27599 Phone: 919-966-8596 Fax: 919-843-5515 |