Keifer Layne Fisher, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

4826 Issued in OK

Practice address

318 W Broadway St
Spiro, OK 74959-2422

Phone

(918) 962-2466

Fax

(918) 962-4004

NPI assigned

Sep 21, 2005

Last updated

Sep 12, 2013By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in OK

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

Medicare enrollment (NPD)

Enrolled

Practice roles

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.

• Spiro Family Dental P.C.

  • Dental Clinic/Center
  • Spiro, OK
  • NPI 1730277740
  NPD (past) Authorized official

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

{
    "created_epoch": "1127260800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1378944000000",
    "number": "1205822681",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "318 W BROADWAY ST",
            "city": "SPIRO",
            "state": "OK",
            "postal_code": "749592422",
            "telephone_number": "918-962-2466",
            "fax_number": "918-962-4004"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "318 W BROADWAY ST",
            "city": "SPIRO",
            "state": "OK",
            "postal_code": "749592422",
            "telephone_number": "918-962-2466",
            "fax_number": "918-962-4004"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FISHER",
        "first_name": "KEIFER",
        "middle_name": "LAYNE",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-21",
        "last_updated": "2013-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "OK",
            "license": "4826",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OKLAHOMA DENTAL LICENSE",
            "identifier": "4826",
            "state": "OK"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100670270A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Bradley Wayne Dedmon, P.D.
• Nancy R. Duncan-Larry, PA
• Olie Melane Duncan, PTA
• Arveitta Yvonne Edge, M.D.
• Coty Fisher
• Ft Smith Hma PBC Management, LLC (Spiro Family Medical)
• Garrison Gray
• Guthrie Clinic, Inc.
• James Brett Guthrie, D.C., APRN
• Colton Harper, PHARM.D.

• General Practice Dentistry in Spiro, OK
• Providers in Spiro, OK by specialty
• General Practice Dentistry in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.