Individual provider Active NPI

Katherine M Fanter, CRNA

  • Registered Nurse
  • Decorah, IA
National Provider Identifier
1629060546
Registry record updated Oct 27, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
D-093740 Issued in IA
Practice address
901 Montgomery St
Winneshiek Medical Center
Decorah, IA 52101-2325
Phone
(515) 221-9222
NPI assigned
Aug 17, 2005
Last updated
Oct 27, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 27, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X D093740 IA
Registered Nurse 163W00000X D-093740 IA Primary

Addresses

Primary practice location

901 Montgomery St
Winneshiek Medical Center
Decorah, IA 52101-2325

Mailing address

1403 Oneota Dr
Decorah, IA 52101-9356
Phone (515) 577-8139

Other identifiers 2

IdentifierTypeStateIssuer
50171OtherIAWELLMARK GROUP #
0439414MedicaidIA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040522000322 IA Practitioner - Certified Registered Nurse Anesthetist (Crna) 4082605589 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
University of Iowa, RJ & L Carver College of Medicine, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cep America - Anesthesia PCGroup PAC ID 3678897915, 849 clinicians
Broadlawns Medical CenterGroup PAC ID 3678466166, 302 clinicians

Practice addresses (Care Compare)

1755 59TH PL
West Des Moines, IA 50266-7737
Phone (515) 358-8000

1801 Hickman Rd
Des Moines, IA 50314-1548
Phone (515) 282-2200

1801 Hickman Rd
Des Moines, IA 50314-1597

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
90.61 of 100Reported as group
Quality
75.16
Promoting interoperability
100
Improvement activities
40
Cost
76.87

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
D-093740IAMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Broadlawns Medical Center CurrentSince Feb 1, 2009 Accepting new patients
Cep America - Anesthesia PC CurrentSince Oct 9, 2025 Accepting new patients
Cep America - Anesthesia PC CurrentSince Oct 9, 2025 Accepting new patients
Cep America - Anesthesia PC Current Accepting new patients
Broadlawns Medical Center CurrentSince Feb 1, 2009 Accepting new patients
Metro Anesthesia & Pain Mngmt LLP Nurse Anesthetist, Certified Registered Past Accepting new patients

Locations

1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 851-7423

1111 6th Ave
Des Moines, IA 50314
Phone (515) 247-3121

1801 Hickman Rd
Des Moines, IA 50314
Phone (515) 282-2200

1801 Hickman Rd
Bldg First
Des Moines, IA 50314

1755 59th Pl
West Des Moines, IA 50266
Phone (515) 247-4240

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1124236800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1761523200000",
    "number": "1629060546",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1403 ONEOTA DR",
            "city": "DECORAH",
            "state": "IA",
            "postal_code": "521019356",
            "telephone_number": "515-577-8139"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "901 MONTGOMERY ST",
            "address_2": "WINNESHIEK MEDICAL CENTER",
            "city": "DECORAH",
            "state": "IA",
            "postal_code": "521012325",
            "telephone_number": "515-221-9222"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FANTER",
        "first_name": "KATHERINE",
        "middle_name": "M",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-08-17",
        "last_updated": "2025-10-27",
        "certification_date": "2025-10-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "IA",
            "license": "D093740",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "IA",
            "license": "D-093740",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLMARK GROUP #",
            "identifier": "50171",
            "state": "IA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0439414",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Decorah, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.