Individual provider Active NPI

Trisha L Fasse, DVM

  • Veterinarian
  • Eden, WI
National Provider Identifier
1124254768
Registry record updated Jun 10, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
VeterinarianTaxonomy code 174M00000X
License
5748-050 Issued in WI
Practice address
N4415A US Highway 45
Eden, WI 53019-1220
Phone
(920) 477-3003
Fax
(920) 477-4001
NPI assigned
Jun 10, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 10, 2009

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Veterinarian 174M00000X 5748-050 WI Primary

Addresses

Primary practice location

N4415A US Highway 45
Eden, WI 53019-1220

Mailing address

N4415A US Highway 45
Eden, WI 53019-1220
Phone (920) 477-3003

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
5748-050WIMDVeterinarian

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1244592000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1244592000000",
    "number": "1124254768",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "N4415A US HIGHWAY 45",
            "city": "EDEN",
            "state": "WI",
            "postal_code": "530191220",
            "telephone_number": "920-477-3003",
            "fax_number": "920-477-4001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "N4415A US HIGHWAY 45",
            "city": "EDEN",
            "state": "WI",
            "postal_code": "530191220",
            "telephone_number": "920-477-3003",
            "fax_number": "920-477-4001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FASSE",
        "first_name": "TRISHA",
        "middle_name": "L",
        "credential": "DVM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-06-10",
        "last_updated": "2009-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174M00000X",
            "taxonomy_group": "",
            "desc": "Veterinarian",
            "state": "WI",
            "license": "5748-050",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Eden, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.