Active NPI
Charles Ross Fisher, PHD
- Clinical Psychologist
- Denver, CO
National Provider Identifier
1063537413
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 303
- Practice address
- 4770 E Iliff
Suite 111
Denver, CO 80222 - Phone
- (303) 918-0658
- Fax
- (303) 798-3690
- NPI assigned
- Mar 21, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 303 | CO | Primary |
Addresses
Primary practice location
4770 E Iliff
Suite 111
Denver, CO 80222
Mailing address
5939 So Datura CT
Littleton, CO 80120-2161
Phone (303) 798-3690
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)
- Not enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 303 | CO | MD | Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1174435200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1063537413",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5939 SO DATURA CT",
"city": "LITTLETON",
"state": "CO",
"postal_code": "801202161",
"telephone_number": "303-798-3690",
"fax_number": "303-798-3690"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4770 E ILIFF",
"address_2": "SUITE 111",
"city": "DENVER",
"state": "CO",
"postal_code": "80222",
"telephone_number": "303-918-0658",
"fax_number": "303-798-3690"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FISHER",
"first_name": "CHARLES",
"middle_name": "ROSS",
"name_prefix": "Dr.",
"credential": "PHD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-03-21",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "CO",
"license": "303",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Denver, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.