Individual provider Active NPI

James Fisk, O.D., PH. D.

  • Optometrist
  • Birmingham, AL
National Provider Identifier
1184644072
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
S985TA558 Issued in AL
Practice address
2531 Rocky Ridge Rd
Suite 116
Birmingham, AL 35243-4445
Phone
(205) 978-4088
Fax
(205) 978-4085
NPI assigned
Jul 20, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X S985TA558 AL Primary

Addresses

Primary practice location

2531 Rocky Ridge Rd
Suite 116
Birmingham, AL 35243-4445

Mailing address

2531 Rocky Ridge Rd
Suite 116
Birmingham, AL 35243-4445
Phone (205) 978-4088

Other identifiers 3

IdentifierTypeStateIssuer
4691470001OtherALMEDICARE PALMETTO GBA
51514016OtherALBLUE CROSS BLUE SHIELD
2200064OtherALUNITED HEALTH CARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050509000628 AL Practitioner - Optometry 6800836925 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

Practice roles

OrganizationSpecialtyStatusNew patients
Vestavia Eye Care, P.C. Optometrist CurrentSince Jan 1, 2003 Accepting new patients
Roswell R. Pfister MD PC Optometrist PastSince May 1, 2006 Accepting new patients
TVPG LLC Optometrist PastSince Apr 22, 2024 Accepting new patients

Locations

2531 Rocky Ridge Rd
Ste 116
Vestavia, AL 35243
Phone (205) 978-4088

Organizations & group practices 3

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": "1153353600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1184644072",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2531 ROCKY RIDGE RD",
            "address_2": "SUITE 116",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352434445",
            "telephone_number": "205-978-4088",
            "fax_number": "205-978-4085"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2531 ROCKY RIDGE RD",
            "address_2": "SUITE 116",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352434445",
            "telephone_number": "205-978-4088",
            "fax_number": "205-978-4085"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FISK",
        "first_name": "JAMES",
        "credential": "O.D., PH. D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-20",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "AL",
            "license": "S985TA558",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PALMETTO GBA",
            "identifier": "4691470001",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "51514016",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTH CARE",
            "identifier": "2200064",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Birmingham, AL

Sources for this page

Verify at the official NPI Registry.