Individual provider Active NPI

Peggy Sue Fisher, FNP, CRNA

  • Family Nurse Practitioner
  • Charleston, WV
National Provider Identifier
1114072469
Registry record updated Feb 6, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
33518 Issued in WV
Practice address
830 Pennsylvania Ave
Suite 301
Charleston, WV 25302-3302
Phone
(304) 346-4455
Fax
(304) 346-4457
NPI assigned
Jan 25, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 6, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 33518 WV Primary
Certified Registered Nurse Anesthetist 367500000X 33518 WV

Addresses

Primary practice location

830 Pennsylvania Ave
Suite 301
Charleston, WV 25302-3302

Mailing address

830 Pennsylvania Ave
Suite 301
Charleston, WV 25302-3302
Phone (304) 346-4455

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
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Randall J. Hill, M.D., P.L.L.C. PastSince Jul 5, 2022 Accepting new patients
Columbia-St Josephs Heathcare System Limited Partnership Past Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1169683200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1360108800000",
    "number": "1114072469",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "830 PENNSYLVANIA AVE",
            "address_2": "SUITE 301",
            "city": "CHARLESTON",
            "state": "WV",
            "postal_code": "253023302",
            "telephone_number": "304-346-4455",
            "fax_number": "304-346-4457"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "830 PENNSYLVANIA AVE",
            "address_2": "SUITE 301",
            "city": "CHARLESTON",
            "state": "WV",
            "postal_code": "253023302",
            "telephone_number": "304-346-4455",
            "fax_number": "304-346-4457"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FISHER",
        "first_name": "PEGGY",
        "middle_name": "SUE",
        "name_prefix": "Ms.",
        "credential": "FNP, CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-25",
        "last_updated": "2013-02-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WV",
            "license": "33518",
            "primary": true
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "WV",
            "license": "33518",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charleston, WV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 6, 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.

Verify at the official NPI Registry.