Individual provider Active NPI

Jeremy W Fisher, PA-C

  • Physician Assistant
  • Columbus, OH
National Provider Identifier
1194084723
Registry record updated Oct 6, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
003401 Issued in OH
Practice address
1605 NW Professional PLZ
Columbus, OH 43220-3866
Phone
(872) 231-3162
NPI assigned
May 16, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 6, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 003401 OH Primary

Addresses

Primary practice location

1605 NW Professional PLZ
Columbus, OH 43220-3866

Mailing address

PO Box 74008272
Chicago, IL 60674-8272
Phone (702) 899-1496

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20140523001583 OH Practitioner - Physician Assistant 4688897499 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Integrated Rehab Consultants LLCGroup PAC ID 7810184892, 162 clinicians

Practice addresses (Care Compare)

1060 E Wind Dr
Heartland Village of Westerville
Westerville, OH 43081-3331
Phone (614) 895-1038

3399 Mill Run Dr
Hilliard, OH 43026-9078
Phone (614) 527-3000

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
003401OHMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Integrated Rehab Consultants LLC CurrentSince Sep 23, 2024 Accepting new patients

Locations

6800 Gender Rd
Canal Winchester, OH 43110
Phone (614) 345-9500

1700 Heinzerling Dr
Columbus, OH 43223
Phone (614) 274-4222

4075 W Granville Rd
Dublin, OH 43017
Phone (614) 201-0541

3929 Hoover Rd
Grove City, OH 43123
Phone (614) 875-7700

3399 Mill Run Dr
Hilliard, OH 43026
Phone (201) 654-5397

4660 Trueman Blvd
Hilliard, OH 43026
Phone (614) 771-4400

1605 NW Professional Plz
Upper Arlington, OH 43220
Phone (614) 451-4577

1060 Eastwind Dr
Westerville, OH 43081
Phone (614) 895-1038

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1337126400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1759708800000",
    "number": "1194084723",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 74008272",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606748272",
            "telephone_number": "702-899-1496",
            "fax_number": "702-977-1496"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1605 NW PROFESSIONAL PLZ",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432203866",
            "telephone_number": "872-231-3162"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FISHER",
        "first_name": "JEREMY",
        "middle_name": "W",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-05-16",
        "last_updated": "2025-10-06",
        "certification_date": "2025-10-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OH",
            "license": "003401",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbus, OH

Sources for this page

Verify at the official NPI Registry.