Individual provider Active NPI

Patricia Kline Fisco, CNP

  • Family Nurse Practitioner
  • Gallipolis, OH
National Provider Identifier
1205860368
Registry record updated Jun 12, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
NP05961 Issued in OH
Practice address
422 Hedgewood Dr
Gallipolis, OH 45631-1114
Phone
(740) 709-1091
Fax
(740) 446-6813
NPI assigned
Jul 11, 2006
Last updated
Jun 12, 2013By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 12, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X NP05961 OH Primary

Addresses

Primary practice location

422 Hedgewood Dr
Gallipolis, OH 45631-1114

Mailing address

422 Hedgewood Dr
Gallipolis, OH 45631-1114
Phone (740) 709-1091

Other identifiers 1

IdentifierTypeStateIssuer
2415863MedicaidOH

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
Credentials
Certified Nurse Practitioner, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
NP05961OHMDFamily Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1152576000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1370995200000",
    "number": "1205860368",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "422 HEDGEWOOD DR",
            "city": "GALLIPOLIS",
            "state": "OH",
            "postal_code": "456311114",
            "telephone_number": "740-709-1091",
            "fax_number": "740-446-6813"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "422 HEDGEWOOD DR",
            "city": "GALLIPOLIS",
            "state": "OH",
            "postal_code": "456311114",
            "telephone_number": "740-709-1091",
            "fax_number": "740-446-6813"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FISCO",
        "first_name": "PATRICIA",
        "middle_name": "KLINE",
        "credential": "CNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-11",
        "last_updated": "2013-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OH",
            "license": "NP05961",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2415863",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Gallipolis, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2013; 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.