Active NPI
Katie J. Fairbourn
- Music Therapist
- Minneapolis, MN
National Provider Identifier
1811730757
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Music Therapist
- Practice address
- 1824 S 5TH St Apt C
Minneapolis, MN 55454-1207 - Phone
- (435) 754-9462
- NPI assigned
- Jun 18, 2024
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Music Therapist | 225A00000X | Primary |
Addresses
Primary practice location
1824 S 5TH St Apt C
Minneapolis, MN 55454-1207
Mailing address
1824 S 5TH St Apt C
Minneapolis, MN 55454-1207
Phone (435) 754-9462
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1718668800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1718668800000",
"number": "1811730757",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1824 S 5TH ST APT C",
"city": "MINNEAPOLIS",
"state": "MN",
"postal_code": "554541207",
"telephone_number": "435-754-9462"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1824 S 5TH ST APT C",
"city": "MINNEAPOLIS",
"state": "MN",
"postal_code": "554541207",
"telephone_number": "435-754-9462"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FAIRBOURN",
"first_name": "KATIE",
"middle_name": "J.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-06-18",
"last_updated": "2024-06-18",
"certification_date": "2024-06-18",
"status": "A"
},
"taxonomies": [
{
"code": "225A00000X",
"taxonomy_group": "",
"desc": "Music Therapist",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Minneapolis, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.