Active NPI
Stacy J Fisher, PT, DPT
- Physical Therapist
- Henderson, NV
National Provider Identifier
1093932014
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 1264
- Practice address
- 874 American Pacific Dr
Henderson, NV 89014-8800 - Phone
- (702) 777-3889
- Fax
- (702) 777-3055
- NPI assigned
- Apr 19, 2007
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 1264 | NV | Primary |
Addresses
Primary practice location
874 American Pacific Dr
Henderson, NV 89014-8800
Mailing address
1044 Dodger Blue Ave
Las Vegas, NV 89123-5329
Phone (702) 614-0871
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1264 | NV | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1176940800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1371513600000",
"number": "1093932014",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1044 DODGER BLUE AVE",
"city": "LAS VEGAS",
"state": "NV",
"postal_code": "891235329",
"telephone_number": "702-614-0871",
"fax_number": "702-614-0872"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "874 AMERICAN PACIFIC DR",
"city": "HENDERSON",
"state": "NV",
"postal_code": "890148800",
"telephone_number": "702-777-3889",
"fax_number": "702-777-3055"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FISHER",
"first_name": "STACY",
"middle_name": "J",
"name_prefix": "Dr.",
"credential": "PT, DPT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-04-19",
"last_updated": "2013-06-18",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "NV",
"license": "1264",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Henderson, NV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.