Phyllis C Fisher, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

6698 Issued in TN

Practice address

1826 N Main Ave
Erwin, TN 37650-8932

Phone

(423) 743-6135

Fax

(423) 743-0035

NPI assigned

Jun 17, 2005

Last updated

Jan 21, 2010By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Mrs. Phyllis C Deel Former name

Medicare fee-for-service enrollment

Enrolled in TN

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

Specialty

Nurse Practitioner

Education

Other, 1995

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Rural Health Services Consortium of Upper East Tennessee IncGroup PAC ID 0941118111, 50 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Rural Health Services Consortium of Upper East Tennessee Inc

  dba Bulls Gap Medical Center

  • Federally Qualified Health Center (FQHC)
  • Bulls Gap, TN
  • NPI 1770583544
  Medicare reassignment Care Compare group NPD
• Rural Health Services Consortium of Upper East Tennessee Inc

  • Federally Qualified Health Center (FQHC)
  • Kingsport, TN
  • NPI 1255130027
  NPD
• Rural Health Services Consortium of Upper East Tennessee Inc

  • Federally Qualified Health Center (FQHC)
  • Rogersville, TN
  • NPI 1679672562
  NPD
• Rural Health Services Consortium of Upper East Tennessee Inc

  dba West Main Medical Center

  • Federally Qualified Health Center (FQHC)
  • Rogersville, TN
  • NPI 1154321966
  NPD (past)

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

{
    "created_epoch": "1118966400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1264032000000",
    "number": "1114922937",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 850",
            "city": "ROGERSVILLE",
            "state": "TN",
            "postal_code": "378570850",
            "telephone_number": "423-743-6135",
            "fax_number": "423-743-0035"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1826 N MAIN AVE",
            "city": "ERWIN",
            "state": "TN",
            "postal_code": "376508932",
            "telephone_number": "423-743-6135",
            "fax_number": "423-743-0035"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FISHER",
        "first_name": "PHYLLIS",
        "middle_name": "C",
        "name_prefix": "Mrs.",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-06-17",
        "last_updated": "2010-01-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "6698",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3343285",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBST",
            "identifier": "3043701",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "PHYLLIS",
            "last_name": "DEEL",
            "middle_name": "C",
            "prefix": "MRS.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Courtney P Garland, DMD
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• Family Nurse Practitioner in Erwin, TN
• Providers in Erwin, TN by specialty
• Family Nurse Practitioner in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 2010; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.