DR. RANDY S FATHEREE DO
NPI 1780671065
Anesthesiology in Saint Peters, MO
About Dr. Randy S Fatheree Do NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
DR. RANDY S FATHEREE DO (NPI 1780671065) is an individual anesthesiology provider in Saint Peters, Missouri, licensed in Missouri (108473) and active in the NPI registry since October 2005. He is enrolled in Medicare PECOS, is affiliated with Jacksonville Memorial Hospital, and is a graduate of At Still University Of Health Sciences, College Of Osteo Med, Kirksville (1995).
NPPES Registry Identity
Specialties & Licenses
Other Identifiers 1
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare and accepts Medicare assignment
Dr. Randy S Fatheree Do is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.
Medicare Billing Reassignment
Medicare enrollment records show Randy Fatheree reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
Jacksonville, IL 62650
- Reassigned Medicare billing, Illinois enrollment
- 39 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Hospital Affiliations CMS Care Compare
Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.
Jacksonville Memorial Hospital
Critical Access Hospitals · Jacksonville, ILOther Providers at the Same Location NPPES 20
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
SAINT PETERS, MO 63376
SAINT PETERS, MO 63376
SAINT PETERS, MO 63376
SAINT PETERS, MO 63376
SAINT PETERS, MO 63376
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 Randy Fatheree's NPI number?
The NPI number for Randy Fatheree is 1780671065. It was assigned to this individual provider in the NPPES registry on October 3, 2005.
Where is Randy Fatheree located?
Randy Fatheree practices at 10 Hospital Dr, Saint Peters, MO 63376. The listed phone number is (314) 895-3828.
What is Randy Fatheree's specialty?
The primary specialty registered for this NPI is Anesthesiology with taxonomy code 207L00000X.
Is Randy Fatheree enrolled in Medicare?
Yes. Randy Fatheree is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.
Which organization bills Medicare for Randy Fatheree's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Randy Fatheree reassigns Medicare benefits to Jacksonville Crnas Inc (Jacksonville, IL). The 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 Randy Fatheree's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
Is Randy Fatheree affiliated with any hospitals?
According to CMS data, Randy Fatheree is affiliated with Jacksonville Memorial Hospital.
When was this NPI record last updated?
The NPPES record for Randy Fatheree was last updated on September 29, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 25 days 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.
# Dr. Randy S Fatheree, DO · NPI 1780671065
Anesthesiology physician in Saint Peters, Missouri. Individual provider, active in the CMS NPPES registry since October 3, 2005.
## Identity
- **NPI:** 1780671065 (Entity type: Individual)
- **Enumerated:** October 3, 2005
- **Primary specialty:** Anesthesiology · taxonomy 207L00000X
- **State license:** 108473 (Missouri)
- **Sole proprietor:** No
## Practice location
- **Address:** 10 HOSPITAL DR, Saint Peters, MO 63376-1659
- **Phone:** (314) 895-3828 · **Fax:** (314) 895-3827
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** Jacksonville Crnas Inc (NPI 1821302068, Jacksonville, IL), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** At Still University Of Health Sciences, College Of Osteo Med, Kirksville, class of 1995
## Record status
- **NPPES last updated:** September 29, 2026
- **Other identifiers:** Medicaid 244631008 (MO)
---
Source: [NPI Profile](https://npiprofile.com/npi/1780671065) · Data from the CMS NPPES public registry.