Active NPI
Kyle Fisher
- Athletic Trainer
- Lewisville, TX
National Provider Identifier
1124471479
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- AT4712
- Practice address
- 1098 W Main St
Lewisville, TX 75067-3518 - Phone
- (940) 631-0647
- NPI assigned
- Jul 21, 2016
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Athletic Trainer | 2255A2300X | AT4712 | TX | Primary |
Addresses
Primary practice location
1098 W Main St
Lewisville, TX 75067-3518
Mailing address
2849 Maple Creek Dr
Ft Worth, TX 76177-2118
Phone (940) 631-0647
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 |
|---|---|---|---|
| AT4712 | TX | MD | Athletic Trainer |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1469059200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1469059200000",
"number": "1124471479",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2849 MAPLE CREEK DR",
"city": "FT WORTH",
"state": "TX",
"postal_code": "761772118",
"telephone_number": "940-631-0647"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1098 W MAIN ST",
"city": "LEWISVILLE",
"state": "TX",
"postal_code": "750673518",
"telephone_number": "940-631-0647"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FISHER",
"first_name": "KYLE",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2016-07-21",
"last_updated": "2016-07-21",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "TX",
"license": "AT4712",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lewisville, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.