Individual provider Active NPI

Fawn Townsend, FNP

  • Family Nurse Practitioner
  • Palo Alto, CA
National Provider Identifier
1467960955
Registry record updated Jun 2, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
2017027605 Issued in WI
Practice address
530 Lytton Ave FL 2
Palo Alto, CA 94301-1541
Phone
(415) 663-5584
Fax
(844) 640-3975
NPI assigned
Jan 18, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 2, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 2017027605 WI Primary

Addresses

Primary practice location

530 Lytton Ave FL 2
Palo Alto, CA 94301-1541

Mailing address

500 McMillen St
Fort Atkinson, WI 53538-1233
Phone (920) 563-5571

Other names 1

  • Fawn Lillian Bingham Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180329001036 WI Practitioner - Nurse Practitioner 3173885217 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Ruby Medical PCGroup PAC ID 0446753297, 6 clinicians

Practice addresses (Care Compare)

12 W 120TH St
New York, NY 10027-6308
Phone (914) 461-5607

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2017027605WIMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Fort Healthcare Inc CurrentSince Mar 6, 2018 Accepting new patients
Fort Healthcare, Inc. CurrentSince Mar 6, 2018 Accepting new patients
Fort Healthcare Inc Current Accepting new patients

Locations

611 Sherman Ave E
Fort Atkinson, WI 53538
Phone (920) 563-6667

500 McMillen St
Fort Atkinson, WI 53538
Phone (920) 563-5571

Interoperability endpoints

  • FHIR API: https://fhir-myrecord.cerner.com/r4/8F7ruIta-JA7ecm4ommy-Q50dF1FkFe4/
  • Direct secure messaging: fawn.townsend.1@17222.direct.athenahealth.com
  • Direct secure messaging: fawn.townsend.1@20088.direct.athenahealth.com

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1516233600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1685664000000",
    "number": "1467960955",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 MCMILLEN ST",
            "city": "FORT ATKINSON",
            "state": "WI",
            "postal_code": "535381233",
            "telephone_number": "920-563-5571"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "530 LYTTON AVE FL 2",
            "city": "PALO ALTO",
            "state": "CA",
            "postal_code": "943011541",
            "telephone_number": "415-663-5584",
            "fax_number": "844-640-3975"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TOWNSEND",
        "first_name": "FAWN",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-01-18",
        "last_updated": "2023-06-02",
        "certification_date": "2023-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WI",
            "license": "2017027605",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "FAWN",
            "last_name": "BINGHAM",
            "middle_name": "LILLIAN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Palo Alto, CA

Sources for this page

Verify at the official NPI Registry.