Individual provider Active NPI

Stephanie Ann Fisher, APRN

  • Family Nurse Practitioner
  • Merritt Island, FL
National Provider Identifier
1033926035
Registry record updated Dec 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
11019086 Issued in FL
Practice address
390 N Courtenay Pkwy
Merritt Island, FL 32953-3456
Phone
(321) 633-3162
NPI assigned
Dec 12, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 12, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 11019086 FL Primary

Addresses

Primary practice location

390 N Courtenay Pkwy
Merritt Island, FL 32953-3456

Mailing address

390 N Courtenay Pkwy
Merritt Island, FL 32953-3456

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250106004000 FL Practitioner - Nurse Practitioner 9335677277 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Medfast Urgent Care Centers LLCGroup PAC ID 1052418837, 73 clinicians

Practice addresses (Care Compare)

206 E New Haven Ave
Melbourne, FL 32901-4504
Phone (321) 802-3311

490 Ctr Lake Dr NE
Suite 200
Palm Bay, FL 32907-1113
Phone (321) 751-7222

5005 Port St John Pkwy
Port St John, FL 32927-4305
Phone (321) 757-7222

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
11019086FLMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Medfast Urgent Care Centers, LLC CurrentSince Dec 1, 2024 Accepting new patients
Medfast Urgent Care Centers LLC Current Accepting new patients
Medfast Urgent Care Centers, LLC CurrentSince Dec 1, 2024 Accepting new patients

Locations

7970 N Wickham Rd
Melbourne, FL 32940
Phone (321) 255-7711

390 N Courtenay Pkwy
Merritt Island, FL 32953
Phone (321) 633-3162

5005 Port St John Pkwy
Port St John, FL 32927
Phone (321) 504-0556

Networks

  • Freedom Health HMO Network

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1733961600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733961600000",
    "number": "1033926035",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "390 N COURTENAY PKWY",
            "city": "MERRITT ISLAND",
            "state": "FL",
            "postal_code": "329533456"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "390 N COURTENAY PKWY",
            "city": "MERRITT ISLAND",
            "state": "FL",
            "postal_code": "329533456",
            "telephone_number": "321-633-3162"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FISHER",
        "first_name": "STEPHANIE",
        "middle_name": "ANN",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-12-12",
        "last_updated": "2024-12-12",
        "certification_date": "2024-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "11019086",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Merritt Island, FL

Sources for this page

Verify at the official NPI Registry.