Individual provider Active NPI

Robert Theodore Fisher Jr., D.C.

  • Chiropractor
  • Pewaukee, WI
National Provider Identifier
1194047316
Registry record updated Feb 16, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
4590-12 Issued in WI
Practice address
1921 Silvernail Rd
Suite 101
Pewaukee, WI 53072-5596
Phone
(262) 542-4700
Fax
(262) 542-7499
NPI assigned
Feb 16, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 16, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 4590-12 WI Primary

Addresses

Primary practice location

1921 Silvernail Rd
Suite 101
Pewaukee, WI 53072-5596

Mailing address

1921 Silvernail Rd
Suite 101
Pewaukee, WI 53072-5596
Phone (262) 542-4700

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
4590-12WIMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Chiro-Med,SC Chiropractor PastSince Jan 1, 1999 Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1266278400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1266278400000",
    "number": "1194047316",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1921 SILVERNAIL RD",
            "address_2": "SUITE 101",
            "city": "PEWAUKEE",
            "state": "WI",
            "postal_code": "530725596",
            "telephone_number": "262-542-4700",
            "fax_number": "262-542-7499"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1921 SILVERNAIL RD",
            "address_2": "SUITE 101",
            "city": "PEWAUKEE",
            "state": "WI",
            "postal_code": "530725596",
            "telephone_number": "262-542-4700",
            "fax_number": "262-542-7499"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FISHER",
        "first_name": "ROBERT",
        "middle_name": "THEODORE",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-02-16",
        "last_updated": "2010-02-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "WI",
            "license": "4590-12",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pewaukee, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 16, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.