Active NPI
Jenna Fassbender, BS
- Social Worker
- Wyoming, MI
National Provider Identifier
1912647116
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- Practice address
- 1111 40TH St SW
Wyoming, MI 49509-4407 - Phone
- (616) 856-6864
- NPI assigned
- Mar 29, 2022
- Last updated
- Mar 29, 2022
- 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 |
|---|---|---|---|---|
| Social Worker | 104100000X | Primary |
Addresses
Primary practice location
1111 40TH St SW
Wyoming, MI 49509-4407
Mailing address
1111 40TH St SW
Wyoming, MI 49509-4407
Phone (616) 856-6864
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1648512000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1648512000000",
"number": "1912647116",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1111 40TH ST SW",
"city": "WYOMING",
"state": "MI",
"postal_code": "495094407",
"telephone_number": "616-856-6864"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1111 40TH ST SW",
"city": "WYOMING",
"state": "MI",
"postal_code": "495094407",
"telephone_number": "616-856-6864"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FASSBENDER",
"first_name": "JENNA",
"credential": "BS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-03-29",
"last_updated": "2022-03-29",
"certification_date": "2022-03-29",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Wyoming, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.