Michael Fellner, PHD, ABPP

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

License

125 Issued in SD

Practice address

1807 Williams St
Sturgis, SD 57785-1142

Phone

(605) 347-3003

NPI assigned

May 2, 2017

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Philosophy

State licenses

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

{
    "created_epoch": "1493683200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1493683200000",
    "number": "1720514367",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1807 WILLIAMS ST",
            "city": "STURGIS",
            "state": "SD",
            "postal_code": "577851142"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1807 WILLIAMS ST",
            "city": "STURGIS",
            "state": "SD",
            "postal_code": "577851142",
            "telephone_number": "605-347-3003"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FELLNER",
        "first_name": "MICHAEL",
        "credential": "PHD, ABPP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-05-02",
        "last_updated": "2017-05-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "SD",
            "license": "125",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jean Marie Earl, ACT
• Lee E Egemo, BS, ACT
• Sara Ellington, ACT, BS
• Empres at Sturgis, LLC
• Elizabeth Susan Erickson
• Sarah Lynn Fitzsimmons, PA-C
• Foothills Assisted Living Inc
• Lauren Lyn Fowler
• Morgan Freeman, B.S, ACT
• Kenneth Fuller, DO

• All providers in Sturgis, SD
• Community/Behavioral Health Agency in South Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 2, 2017; 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.