Active NPI
Victoria Fetter, M.D.
- Psychiatry Physician
- Milwaukee, WI
National Provider Identifier
1366420150
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- 16473
- Practice address
- 633 W Wisconsin Ave
Ste 401
Milwaukee, WI 53203-1918 - Phone
- (414) 272-4673
- Fax
- (414) 224-5457
- NPI assigned
- Jan 3, 2006
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | 16473 | WI | Primary |
Addresses
Primary practice location
633 W Wisconsin Ave
Ste 401
Milwaukee, WI 53203-1918
Mailing address
6400 Industrial Loop
Greendale, WI 53129-2452
Phone (411) 423-4100
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 30875000 | Medicaid | WI |
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
- HHS exclusion list flag
- Flagged The directory lists this NPI on an HHS exclusion list.
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 16473 | WI | MD | Psychiatric/Mental Health Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Multi-Cultural Counseling Services II Inc. | Past | Accepting new patients | |
| Allied Counseling Services, S.C. | Past | Accepting new patients | |
| Visiting Medical Associates | Past | Accepting new patients |
Organizations & group practices 3
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Clinical Psychologist
- Waukesha, WI
- NPI 1003867813
-
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Milwaukee, WI
- NPI 1962575266
-
- Internal Medicine Physician
- Greendale, WI
- NPI 1083954630
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1136246400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1482883200000",
"number": "1366420150",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6400 INDUSTRIAL LOOP",
"city": "GREENDALE",
"state": "WI",
"postal_code": "531292452",
"telephone_number": "411-423-4100",
"fax_number": "414-423-4134"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "633 W WISCONSIN AVE",
"address_2": "STE 401",
"city": "MILWAUKEE",
"state": "WI",
"postal_code": "532031918",
"telephone_number": "414-272-4673",
"fax_number": "414-224-5457"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FETTER",
"first_name": "VICTORIA",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-01-03",
"last_updated": "2016-12-28",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "WI",
"license": "16473",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "30875000",
"state": "WI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Milwaukee, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 28, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.