Individual provider Active NPI

David N Fisher, PA-C

  • Medical Physician Assistant
  • Saint Louis, MO
National Provider Identifier
1144786351
Registry record updated Oct 5, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
2019004823 Issued in MO
Practice address
3009 N Ballas Rd Ste 359C
Saint Louis, MO 63131-2324
Phone
(314) 996-3520
NPI assigned
Feb 12, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 5, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 2019004823 MO Primary

Addresses

Primary practice location

3009 N Ballas Rd Ste 359C
Saint Louis, MO 63131-2324

Mailing address

3009 N Ballas Rd Ste 359C
Saint Louis, MO 63131-2324
Phone (314) 996-3520

Other practice location 1

13861 Manchester Rd
Ballwin, MO 63011-4503
Phone (636) 220-9333

Electronic endpoints 1

TypeEndpointUseAffiliation
FHIR URL https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/ Health Information Exchange (HIE)

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
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

Enrollment IDStateProvider typePAC IDDetails
I20190314000989 MO Practitioner - Physician Assistant 1456691294 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Physician Groups LCGroup PAC ID 3072421254, 526 clinicians

Practice addresses (Care Compare)

1110 Highlands Plaza Dr E
Saint Louis, MO 63110-1351
Phone (314) 273-0195

2630 Hwy K
O Fallon, MO 63368-6624
Phone (636) 240-5454

3015 N Ballas Rd
Saint Louis, MO 63131-2329
Phone (314) 996-5772

Hospital & facility affiliations

  • Missouri Baptist Medical Center Hospital, Saint Louis, MO, CCN 260108
  • Barnes-Jewish West County Hospital Hospital, Creve Coeur, MO, CCN 260162
  • Parkland Health Center Hospital, Farmington, MO, CCN 260163

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Interoperability endpoints

  • Direct secure messaging: david.fisher.p1@direct.sig.nextgenshare.com

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 and National Provider Directory roles.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1549929600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696464000000",
    "number": "1144786351",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3009 N BALLAS RD STE 359C",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631312324",
            "telephone_number": "314-996-3520"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3009 N BALLAS RD STE 359C",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631312324",
            "telephone_number": "314-996-3520"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "13861 Manchester Rd",
            "address_purpose": "LOCATION",
            "city": "Ballwin",
            "state": "MO",
            "postal_code": "630114503",
            "country_code": "US",
            "telephone_number": "636-220-9333",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FISHER",
        "first_name": "DAVID",
        "middle_name": "N",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-02-12",
        "last_updated": "2023-10-05",
        "certification_date": "2023-10-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "MO",
            "license": "2019004823",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/",
            "affiliation": "N",
            "endpointDescription": "BJC",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "3009 N Ballas Rd Ste 359C",
            "city": "Saint Louis",
            "state": "MO",
            "country_code": "US",
            "postal_code": "631312324",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

Verify at the official NPI Registry.