Angela Fasnacht, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

55405 Issued in MN

Practice address

15650 Cedar Ave
Fairview Clinic Apple Valley
Apple Valley, MN 55124

Phone

(952) 997-4100

NPI assigned

Apr 23, 2010

Sex

Female

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)

Enrolled

Credentials

Doctor of Medicine

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

{
    "created_epoch": "1271980800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1381363200000",
    "number": "1982921599",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15650 CEDAR AVE",
            "address_2": "FAIRVIEW CLINIC APPLE VALLEY",
            "city": "APPLE VALLEY",
            "state": "MN",
            "postal_code": "55124",
            "telephone_number": "952-997-4100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15650 CEDAR AVE",
            "address_2": "FAIRVIEW CLINIC APPLE VALLEY",
            "city": "APPLE VALLEY",
            "state": "MN",
            "postal_code": "55124",
            "telephone_number": "952-997-4100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FASNACHT",
        "first_name": "ANGELA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-04-23",
        "last_updated": "2013-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MN",
            "license": "55405",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Family Medicine Physician in Apple Valley, MN
• Providers in Apple Valley, MN by specialty
• Family Medicine Physician in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2013; 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.