NPIMap

Individual provider Active NPI

Laura Renee Fish

  • Emergency Medicine Physician
  • Gainesville, FL
National Provider Identifier
1053510404
Registry record updated Apr 20, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
ME102454 Issued in FL
Practice address
1600 SW Archer Rd
Gainesville, FL 32610-3003
Phone
(352) 265-5911
NPI assigned
Jul 16, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 20, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X ME102454 FL Primary

Addresses

Primary practice location

1600 SW Archer Rd
Gainesville, FL 32610-3003

Mailing address

PO Box 918025
Orlando, FL 32891-8025
Phone (352) 265-5911

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080617000357 NC Practitioner - Emergency Medicine 9133290299 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Brody School of Medicine at East Carolina University, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Duke University Health System, IncGroup PAC ID 2567372345, 1,083 clinicians

Practice addresses (Care Compare)

3643 N Roxboro St
Durham, NC 27704-2702
Phone (919) 470-5356

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of nail tissue1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
ME102454FLMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Duke University Health System, Inc. CurrentSince Aug 1, 2014 Accepting new patients
Duke University Health System, Inc. CurrentSince Aug 1, 2014 Accepting new patients
Duke University Health System, Inc. Current Accepting new patients
Nes of Northern Florida Inc Emergency Medicine Past Accepting new patients
Gainesville Emergency Medical Associates PA Emergency Medicine Past Accepting new patients
Emergency Medicine Physicians of Craven County, PLLC Emergency Medicine Past Accepting new patients
Gainesville Urgent Care Associates, PA Emergency Medicine Past Accepting new patients
Emergency Medicine Physicians of Lenoir County PLLC Emergency Medicine Past Accepting new patients

Locations

3643 N Roxboro St
Durham, NC 27704
Phone (919) 470-6186

3400 Wake Forest Rd
Raleigh, NC 27609
Phone (919) 954-3000

Interoperability endpoints

  • Direct secure messaging: lfish226513@direct.medicine.duke.edu
  • Direct secure messaging: lfish15376@direct.shands.ufl.edu

Organizations & group practices 8

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.

Hospital & facility affiliations 8

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1184544000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1303257600000",
    "number": "1053510404",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 918025",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328918025",
            "telephone_number": "352-265-5911"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 SW ARCHER RD",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326103003",
            "telephone_number": "352-265-5911"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FISH",
        "first_name": "LAURA",
        "middle_name": "RENEE",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-07-16",
        "last_updated": "2011-04-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "FL",
            "license": "ME102454",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gainesville, FL

Sources for this page

Verify at the official NPI Registry.