Active NPI
Myka Dawn Fisher, NP
- Family Nurse Practitioner
- Evans, CO
National Provider Identifier
1154558302
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- NP 10043
- Practice address
- 2930 11TH Ave
Evans, CO 80620-1011 - Phone
- (970) 353-9403
- Fax
- (970) 353-9906
- NPI assigned
- Jun 15, 2009
- 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 |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | NP 10043 | CO | Primary |
Addresses
Primary practice location
2930 11TH Ave
Evans, CO 80620-1011
Mailing address
2930 11TH Ave
Evans, CO 80620-1011
Phone (970) 353-9403
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 07654898 | Medicaid | CO |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CO
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20100114000425 | CO | Practitioner - Nurse Practitioner | 5991846875 | Reassigns benefits to 2 organizations |
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- Other, 2009
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Banner Health Physicians Colorado LLC
Practice addresses (Care Compare)
1801 16TH St
Greeley, CO 80631-5154
Phone (970) 810-4121
2000 Boise Ave
Loveland, CO 80538-5006
Phone (970) 820-4640
615 Fairhurst St
Sterling, CO 80751-4523
Phone (970) 522-0122
Hospital & facility affiliations
- Banner North Colorado Medical Center
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| NP 10043 | CO | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Banner Health Physicians Colorado LLC | Current | Accepting new patients | |
| Banner Health Physicians Colorado LLC | Current | Accepting new patients | |
| Banner Hospital Based Physicians Colorado LLC | Current | Accepting new patients | |
| Banner Hospital Based Physicians Colorado LLC | Current | Accepting new patients | |
| Banner Health Physicians Colorado LLC | Past | Accepting new patients | |
| Greeley Internal Medicine & Nephrology | Past | Accepting new patients |
Locations
1801 16th St
Greeley, CO 80631
Phone (970) 352-4121
1801 16th St
Ste C2B
Greeley, CO 80631
Phone (970) 810-4121
1800 15th St
Ste 210
Greeley, CO 80631
Phone (970) 352-8216
Organizations & group practices 6
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.
-
- Multi-Specialty Clinic/Center
- Greeley, CO
- NPI 1154679637
CO
-
- Multi-Specialty Clinic/Center
- Torrington, WY
- NPI 1215375688
-
- Critical Care Medicine (Internal Medicine) Physician
- Phoenix, AZ
- NPI 1376304758
-
- Multi-Specialty Clinic/Center
- Windsor, CO
- NPI 1831476381
-
- Internal Medicine Physician
- Greeley, CO
- NPI 1548443039
Hospital & facility affiliations 12
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": "1245024000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1370476800000",
"number": "1154558302",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2930 11TH AVE",
"city": "EVANS",
"state": "CO",
"postal_code": "806201011",
"telephone_number": "970-353-9403",
"fax_number": "970-353-9906"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2930 11TH AVE",
"city": "EVANS",
"state": "CO",
"postal_code": "806201011",
"telephone_number": "970-353-9403",
"fax_number": "970-353-9906"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FISHER",
"first_name": "MYKA",
"middle_name": "DAWN",
"credential": "NP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2009-06-15",
"last_updated": "2013-06-06",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "CO",
"license": "NP 10043",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "07654898",
"state": "CO"
}
],
"endpoints": [],
"other_names": []
}Other providers in Evans, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 6, 2013; 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.