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Marcy Ann Fadness, PA

Individual provider Active NPI Medical Physician Assistant · Decorah, IA

NPI 1508872276 · NPPES record last updated Apr 7, 2014

Key facts

NPI
1508872276
Entity type
Individual (NPI type 1)
Primary specialty
Medical Physician Assistant 363AM0700X
License
000914 (IA)
Practice address
911 S Mill St
Decorah, IA 52101-2023
Phone
(563) 382-1200
Fax
(563) 382-1211
NPI assigned
Aug 1, 2006
Sex
Female
Sole proprietor
No

Organizations & group practices 5

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.

Medicare participation

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

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Family Care Clinic PC Past Accepting new patients
Gundersen Clinic LTD Past Accepting new patients
Floyd County Memorial Hospital Commission Past Accepting new patients
Iowa Sleep Disorders Center, P.C. Past Accepting new patients
Michael McCubbin, MD, PC Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: mfadness78491@direct.gundersenhealth.org

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 000914 IA
Medical Physician Assistant 363AM0700X 000914 IA Yes

Addresses

Primary practice location

911 S Mill St
Decorah, IA 52101-2023

Mailing address

PO Box 96
911 S. Mill Street
Decorah, IA 52101-0096
Phone (563) 382-1200

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Apr 7, 2014.

{
    "created_epoch": "1154390400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1396828800000",
    "number": "1508872276",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 96",
            "address_2": "911 S. MILL STREET",
            "city": "DECORAH",
            "state": "IA",
            "postal_code": "521010096",
            "telephone_number": "563-382-1200",
            "fax_number": "563-382-1211"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "911 S MILL ST",
            "city": "DECORAH",
            "state": "IA",
            "postal_code": "521012023",
            "telephone_number": "563-382-1200",
            "fax_number": "563-382-1211"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FADNESS",
        "first_name": "MARCY",
        "middle_name": "ANN",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-01",
        "last_updated": "2014-04-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IA",
            "license": "000914",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "IA",
            "license": "000914",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Decorah, IA

All providers in Decorah, IA · Medical Physician Assistant in Iowa

Sources for this page

Verify at the official NPI Registry.