Active NPI
Terrence Deshon Fisher
- Driver
- Cordova, TN
National Provider Identifier
1083977979
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Driver
- License
- 110006378
- Practice address
- 1657 Belledeer Dr E
Cordova, TN 38016-0429 - Phone
- (901) 483-4575
- NPI assigned
- Jun 17, 2012
- Last updated
- Jun 17, 2012
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Driver | 172A00000X | 110006378 | TN | Primary |
Addresses
Primary practice location
1657 Belledeer Dr E
Cordova, TN 38016-0429
Mailing address
1657 Belledeer Dr E
Cordova, TN 38016-0429
Phone (901) 483-4575
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 110006378 | TN | MD | Driver |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1339891200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1339891200000",
"number": "1083977979",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1657 BELLEDEER DR E",
"city": "CORDOVA",
"state": "TN",
"postal_code": "380160429",
"telephone_number": "901-483-4575"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1657 BELLEDEER DR E",
"city": "CORDOVA",
"state": "TN",
"postal_code": "380160429",
"telephone_number": "901-483-4575"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FISHER",
"first_name": "TERRENCE",
"middle_name": "DESHON",
"name_prefix": "Mr.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2012-06-17",
"last_updated": "2012-06-17",
"status": "A"
},
"taxonomies": [
{
"code": "172A00000X",
"taxonomy_group": "",
"desc": "Driver",
"state": "TN",
"license": "110006378",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Cordova, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 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.