Individual provider Active NPI

Catherine A Wille, M.D.

  • Family Medicine Physician
  • Fresno, CA
National Provider Identifier
1356346597
Registry record updated Feb 24, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
G43660 Issued in CA
Practice address
4011 N Fresno St
Ste 101
Fresno, CA 93726-4028
Phone
(559) 227-6691
Fax
(559) 227-3765
NPI assigned
Jun 15, 2005
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 24, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X G43660 CA Primary

Addresses

Primary practice location

4011 N Fresno St
Ste 101
Fresno, CA 93726-4028

Mailing address

4011 N Fresno St
Ste 101
Fresno, CA 93726-4028
Phone (559) 227-6691

Other identifiers 1

IdentifierTypeStateIssuer
00G436600MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100921000389 CA Practitioner - Family Practice 1759406283 Practice locations: Fresno, CA

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
43660CAMDPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
G43660CAMDFamily Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1118793600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1393200000000",
    "number": "1356346597",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4011 N FRESNO ST",
            "address_2": "STE 101",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937264028",
            "telephone_number": "559-227-6691",
            "fax_number": "559-227-3765"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4011 N FRESNO ST",
            "address_2": "STE 101",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937264028",
            "telephone_number": "559-227-6691",
            "fax_number": "559-227-3765"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLE",
        "first_name": "CATHERINE",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-06-15",
        "last_updated": "2014-02-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "G43660",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G436600",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fresno, CA

Sources for this page

Verify at the official NPI Registry.