Individual provider Active NPI

Katie R. Fassbinder, M.D.

  • Psychiatry Physician
  • Viroqua, WI
National Provider Identifier
1710936588
Registry record updated Apr 15, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
1343-TEP Issued in WI
Practice address
210 Airport Rd
Viroqua, WI 54665-1159
Phone
(608) 638-7420
Fax
(608) 638-7429
NPI assigned
May 9, 2006
Last updated
Apr 15, 2014By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 15, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 1343-TEP WI Primary
Student in an Organized Health Care Education/Training Program 390200000X 49741 WI

Addresses

Primary practice location

210 Airport Rd
Viroqua, WI 54665-1159

Mailing address

210 Airport Rd
PO Box 189
Viroqua, WI 54665-1159
Phone (608) 638-7420

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20091012000083 WI Practitioner - Psychiatry 8325184039 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
1343-TEPWIMDPsychiatry Physician
49741WIMDStudent in an Organized Health Care Education/Training Program

Practice roles

OrganizationSpecialtyStatusNew patients
County of la Crosse CurrentSince Jun 26, 2018 Accepting new patients
County of la Crosse CurrentSince Jun 26, 2018 Accepting new patients
County of Monroe CurrentSince Nov 3, 2015 Accepting new patients
County of Monroe CurrentSince Nov 3, 2015 Accepting new patients
Crawford County CCS PastSince Mar 19, 2017 Accepting new patients

Locations

300 4th St N
La Crosse, WI 54601
Phone (608) 784-4357

210 W Oak St
Sparta, WI 54656
Phone (608) 269-8600

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1147132800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1397520000000",
    "number": "1710936588",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "210 AIRPORT RD",
            "address_2": "PO BOX 189",
            "city": "VIROQUA",
            "state": "WI",
            "postal_code": "546651159",
            "telephone_number": "608-638-7420",
            "fax_number": "608-638-7429"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "210 AIRPORT RD",
            "city": "VIROQUA",
            "state": "WI",
            "postal_code": "546651159",
            "telephone_number": "608-638-7420",
            "fax_number": "608-638-7429"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FASSBINDER",
        "first_name": "KATIE",
        "middle_name": "R.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-09",
        "last_updated": "2014-04-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "WI",
            "license": "1343-TEP",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "WI",
            "license": "49741",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Viroqua, WI

Sources for this page

Verify at the official NPI Registry.