Individual provider Active NPI

Kyle S Fisher, MD

  • Anesthesiology Physician
  • Boone, NC
National Provider Identifier
1053424416
Registry record updated Jan 18, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
31133 Issued in NC
Practice address
895 State Farm Rd Ste 401
Boone, NC 28607-4917
Phone
(828) 264-4691
Fax
(828) 265-4288
NPI assigned
Aug 17, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 18, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 31133 NC Primary

Addresses

Primary practice location

895 State Farm Rd Ste 401
Boone, NC 28607-4917

Mailing address

895 State Farm Rd Ste 401
Boone, NC 28607-4917
Phone (828) 264-4691

Other identifiers 1

IdentifierTypeStateIssuer
8932206MedicaidNC

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)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
31133NCMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Appalachian Regional Pain Center PastSince Jul 18, 1994 Accepting new patients

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1155772800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1326844800000",
    "number": "1053424416",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "895 STATE FARM RD STE 401",
            "city": "BOONE",
            "state": "NC",
            "postal_code": "286074917",
            "telephone_number": "828-264-4691",
            "fax_number": "828-265-4288"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "895 STATE FARM RD STE 401",
            "city": "BOONE",
            "state": "NC",
            "postal_code": "286074917",
            "telephone_number": "828-264-4691",
            "fax_number": "828-265-4288"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FISHER",
        "first_name": "KYLE",
        "middle_name": "S",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-17",
        "last_updated": "2012-01-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "NC",
            "license": "31133",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8932206",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Boone, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 2012; 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.