Individual provider Active NPI

Kathleen Ann Fitzsimmons, BS

  • Case Manager/Care Coordinator
  • La Crosse, WI
National Provider Identifier
1639395536
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Case Manager/Care CoordinatorTaxonomy code 171M00000X
License
3304-120 Issued in WI
Practice address
1407 Saint Andrew St
Ste. 100
La Crosse, WI 54603-3301
Phone
(608) 785-6072
NPI assigned
Apr 18, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Case Manager/Care Coordinator 171M00000X 3304-120 WI Primary

Addresses

Primary practice location

1407 Saint Andrew St
Ste. 100
La Crosse, WI 54603-3301

Mailing address

2702 32ND St S
La Crosse, WI 54601-7453
Phone (608) 788-2740

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
Credentials
Bachelor of Science

State licenses

LicenseStateTypeSpecialty
3304-120WIMDCase Manager/Care Coordinator

NPI Registry JSON

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

{
    "created_epoch": "1176854400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1639395536",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2702 32ND ST S",
            "city": "LA CROSSE",
            "state": "WI",
            "postal_code": "546017453",
            "telephone_number": "608-788-2740"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1407 SAINT ANDREW ST",
            "address_2": "STE. 100",
            "city": "LA CROSSE",
            "state": "WI",
            "postal_code": "546033301",
            "telephone_number": "608-785-6072"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FITZSIMMONS",
        "first_name": "KATHLEEN",
        "middle_name": "ANN",
        "name_prefix": "Ms.",
        "credential": "BS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-18",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": "WI",
            "license": "3304-120",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in La Crosse, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.