Cheryl Fish, NP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

60167 Issued in ID

Practice address

6140 W Curtisian Ave
Ste 200
Boise, ID 83704

Phone

(208) 302-0000

Fax

(208) 302-0055

NPI assigned

Dec 16, 2018

Sex

Female

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Enrolled in ID

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Christine Foy, FNP-C

  • Family Nurse Practitioner
  • Boise, ID
  • NPI 1326891151

  ID

  Medicare reassignment
• Megan Nicola, FNP-C

  • Family Nurse Practitioner
  • Garden City, ID
  • NPI 1720847551

  ID

  Medicare reassignment
• Heather Ann Stafford, NP-C

  • Adult Health Nurse Practitioner
  • Boise, ID
  • NPI 1912416413

  ID

  Medicare reassignment
• Bailey Tomazich

  • Family Nurse Practitioner
  • Boise, ID
  • NPI 1871200758

  ID

  Medicare reassignment

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.

• Legacy Primary Care, LLC

  • Primary Care Clinic/Center
  • Meridian, ID
  • NPI 1568289247
  NPD Authorized official
• Legacy Primary Care, PLLC

  • Family Medicine Physician
  • Sherman, TX
  • NPI 1255907473

  Family Medicine

  NPD (past)

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

{
    "created_epoch": "1544918400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1561075200000",
    "number": "1083185235",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3340 E GOLDSTONE DR",
            "city": "MERIDIAN",
            "state": "ID",
            "postal_code": "83642",
            "telephone_number": "208-302-0000",
            "fax_number": "208-302-0055"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6140 W CURTISIAN AVE",
            "address_2": "STE 200",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "83704",
            "telephone_number": "208-302-0000",
            "fax_number": "208-302-0055"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FISH",
        "first_name": "CHERYL",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-12-16",
        "last_updated": "2019-06-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CA",
            "license": "807738",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "95010116",
            "primary": false
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "CA",
            "license": "95010116",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "ID",
            "license": "60167",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• First Step LLC
• Charlaine K Fisch, CRNA
• Delores Marie Fischer, RN
• Andrew Fiscus
• Boyce Kyle Fish, D.O.
• Earl R. Fish, PHARMD
• Mary Elizabeth Fish, LPC
• Jon R Fishburn, MD
• Chadwick Alden Fisher, PA
• Christopher William Fisher, DC

• All providers in Boise, ID
• Nurse Practitioner in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.