Individual provider Active NPI

Nicole Fischbach, FNP

  • Family Medicine Physician
  • Mankato, MN
National Provider Identifier
1801381603
Registry record updated Jul 17, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
1831472 Issued in MN
Practice address
1421 Premier Dr
Mankato, MN 56001-6076
Phone
(507) 385-3964
NPI assigned
Jun 25, 2018
Last updated
Jul 17, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 17, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 1831472 MN Primary

Addresses

Primary practice location

1421 Premier Dr
Mankato, MN 56001-6076

Mailing address

61683 243Rd St
Madison Lake, MN 56063-4454
Phone (651) 387-3276

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address nicolefischbach@mklt.allscriptsdirect.net Direct

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
1831472MNMDFamily Medicine Physician

Interoperability endpoints

  • Direct secure messaging: nicole.fischbach@811393367080964.direct.elationemr.com
  • Direct secure messaging: nicolefischbach@mklt.allscriptsdirect.net

NPI Registry JSON

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

{
    "created_epoch": "1529884800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1594944000000",
    "number": "1801381603",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "61683 243RD ST",
            "city": "MADISON LAKE",
            "state": "MN",
            "postal_code": "560634454",
            "telephone_number": "651-387-3276"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1421 PREMIER DR",
            "city": "MANKATO",
            "state": "MN",
            "postal_code": "560016076",
            "telephone_number": "507-385-3964"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FISCHBACH",
        "first_name": "NICOLE",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-06-25",
        "last_updated": "2020-07-17",
        "certification_date": "2020-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MN",
            "license": "1831472",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "nicolefischbach@mklt.allscriptsdirect.net",
            "affiliation": "N",
            "endpointDescription": "Mankato Clinic Direct ID, Allscripts Community",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1421 Premier Dr",
            "city": "Mankato",
            "state": "MN",
            "country_code": "US",
            "postal_code": "560016076",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Mankato, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2020; 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.