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JERRY FENWICK MD
NPI 1366477549
Emergency Medicine in Springfield, MO

Active since July 12, 2006PECOS Enrolled
771 N SUMMERCREEK CT, SPRINGFIELD, MO 65802(417) 771-4548 Get Directions Write a Review

NPPES record last updated: January 20, 2021. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Jan 20, 2021, Dec 27, 2018, Mar 8, 2018 (3 updates tracked since 2018).

About Jerry Fenwick Md NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

JERRY FENWICK MD (NPI 1366477549) is an individual emergency medicine provider in Springfield, Missouri, licensed in Missouri (110179) and active in the NPI registry since July 2006. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1366477549
Entity TypeIndividualMale
Primary Taxonomy207P00000X
Provider Legal NameJERRY FENWICKCredential: MD
Location Address771 N SUMMERCREEK CTSpringfield, MO 65802-7249
Mailing Address771 N Summercreek CtSpringfield, MO 65802-7249 · (417) 714-4548
Phone(417) 771-4548
Sole ProprietorNo
Enumeration DateJuly 12, 2006
Last NPPES UpdateJanuary 20, 20213 updates tracked since enumeration
NPPES CertifiedJanuary 20, 2021
✔ NPI 1366477549 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyEmergency MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207P00000X
Licenses✔ Licensed in MO · 110179✔ Licensed in SC · 18407
Definition
An emergency physician focuses on the immediate decision making and action necessary to prevent death or any further disability both in the pre-hospital setting by directing emergency medical technicians and in the emergency department. The emergency physician provides immediate recognition, evaluation, care, stabilization and disposition of a generally diversified population of adult and pediatric patients in response to acute illness and injury.
771 N SUMMERCREEK CT, Springfield, MO 65802
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Other Names 1

Other Name (5)Jerry Lynn Fenwick

Other Identifiers 3

Medicaid1366477549MO
MedicaidG38753SC
Medicaid208524116MO

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Jerry Fenwick Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignments

2

Medicare enrollment records show Jerry Fenwick reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

417 Health Care
13 mi
Family Medicine
830 W MOUNT VERNON ST STE 10
Nixa, MO 65714
  • Reassigned Medicare billing, Missouri enrollment
  • 2 clinicians in this Medicare group
NPI 1689321218 (417) 374-4141
Virtualmed Nexus
795 mi
Public Health & General Preventive Medicine
240 S WOLCOTT ST STE 10B
Casper, WY 82601
  • Reassigned Medicare billing, Missouri enrollment
NPI 1821844895 (317) 408-3056

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 65802 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$81.64 typical visit price
range $52.28 – $161.24
Typical copayment $20.41 (range $13.07 – $40.31)
Most-billed visit code 99203
Established Patient
$93.24 typical visit price
range $16.30 – $131.05
Typical copayment $23.31 (range $4.07 – $32.76)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Jerry Fenwick's NPI number?

The NPI number for Jerry Fenwick is 1366477549. It was assigned to this individual provider in the NPPES registry on July 12, 2006. The provider is also known as Jerry Lynn Fenwick.

Where is Jerry Fenwick located?

Jerry Fenwick practices at 771 N Summercreek Ct, Springfield, MO 65802. The listed phone number is (417) 771-4548.

What is Jerry Fenwick's specialty?

The primary specialty registered for this NPI is Emergency Medicine with taxonomy code 207P00000X.

Is Jerry Fenwick enrolled in Medicare?

Yes. Jerry Fenwick is registered in the Medicare PECOS enrollment system.

Which organizations bill Medicare for Jerry Fenwick's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Jerry Fenwick reassigns Medicare benefits to 2 organizations: 417 Health Care (Nixa, MO) and Virtualmed Nexus (Casper, WY). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Jerry Fenwick's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Jerry Fenwick was last updated on January 20, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.