1. Home
  2. Directory
  3. South Dakota
  4. Brookings
  5. Physician Assistant
  6. NPI Profile
Newly Listed Provider — this NPI profile has been added to the NPI registry within the last 90 days.

MARY FANTA
NPI 1508774126
Physician Assistant in Brookings, SD

Active since September 01, 2026
400 22ND AVE, BROOKINGS, SD 57006(605) 697-9500 Get Directions Write a Review

NPPES record added: September 1, 2026. Verified against the NPPES registry weekly; last sync: September 06, 2026.

About Mary Fanta NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MARY FANTA (NPI 1508774126) is an individual physician assistant in Brookings, South Dakota and active in the NPI registry since September 2026.

NPPES Registry Identity

NPI1508774126
Entity TypeIndividualFemale
Primary Taxonomy363A00000X
Provider Legal NameMARY FANTA
Location Address400 22ND AVEBrookings, SD 57006-2447
Mailing Address1602 1st StBrookings, SD 57006-2617 · (605) 660-6623
Phone(605) 697-9500
Sole ProprietorNo
Enumeration DateSeptember 1, 2026
NPPES CertifiedSeptember 1, 2026
✔ NPI 1508774126 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363A00000X
Definition
A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.
400 22ND AVE, Brookings, SD 57006
Open in Google Maps ↗

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

AVERA MCKENNAN
Clinical Medical Laboratory
400 22ND AVE
BROOKINGS, SD 57006
Brookings County (605) 697-9500
NEPHI JONES DPM
Podiatrist (Foot & Ankle Surgery)
400 22ND AVE
BROOKINGS, SD 57006
Brookings County (605) 697-9500
KATIE TETZLAFF PA-C
Physician Assistant
400 22ND AVE
BROOKINGS, SD 57006
Brookings County (605) 697-9500
DR. JILL D KRUSE DO
Family Medicine
400 22ND AVE
BROOKING, SD 57006
Brookings County (605) 697-9500
MS. SANDRA M. KUTSCHER PT
Physical Therapist
400 22ND AVE
BROOKINGS, SD 57006
Brookings County (605) 697-9500
CITY OF BROOKINGS
Clinic/Center (Multi-Specialty)
400 22ND AVE
BROOKINGS, SD 57006
Brookings County (605) 697-9500
MEGAN LYNN HADLEY PA-C
Physician Assistant
400 22ND AVE
BROOKINGS, SD 57006
Brookings County (605) 697-9500
KIP A KLUDT PT
Physical Therapist
400 22ND AVE
BROOKINGS, SD 57006
Brookings County (605) 697-9500

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Mary Fanta's NPI number?

The NPI number for Mary Fanta is 1508774126. It was assigned to this individual provider in the NPPES registry on September 1, 2026.

Where is Mary Fanta located?

Mary Fanta practices at 400 22nd Ave, Brookings, SD 57006. The listed phone number is (605) 697-9500.

What is Mary Fanta's specialty?

The primary specialty registered for this NPI is Physician Assistant with taxonomy code 363A00000X.

When was this NPI record last updated?

The NPPES record for Mary Fanta was last updated on September 1, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 days ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.