Individual provider Active NPI

Patricia A Moxham-Fisher, ANP

  • Acute Care Nurse Practitioner
  • Dover, NH
National Provider Identifier
1255407391
Registry record updated Jun 28, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
086609-23 Issued in NH
Practice address
19 Old Rollinsford Rd BLDG B
Dover, NH 03820-2807
Phone
(603) 516-4265
NPI assigned
Nov 28, 2006
Last updated
Jun 28, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 28, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X 5105 CO
Acute Care Nurse Practitioner 363LA2100X 086609-23 NH Primary

Addresses

Primary practice location

19 Old Rollinsford Rd BLDG B
Dover, NH 03820-2807

Mailing address

PO Box 412503
Boston, MA 02241-2503
Phone (617) 726-3884

Other practice location 1

3235 Mill Vista Rd
Highlands Ranch, CO 80129-2440
Phone (303) 876-8320

Other identifiers 1

IdentifierTypeStateIssuer
3131522MedicaidNH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
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
I20111102000592 CO Practitioner - Nurse Practitioner 8729089701 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
5105COMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Abc Heart Health LLC CurrentSince Sep 27, 2022 Accepting new patients
Abc Heart Health LLC CurrentSince Sep 27, 2022 Accepting new patients

Locations

101 W Hampden Ave
Unit B
Englewood, CO 80110
Phone (303) 439-7400

401 W Hampden Pl
Ste 260
Englewood, CO 80110
Phone (303) 761-5454

Interoperability endpoints

  • Direct secure messaging: patricia.moxham.fisher.1@30163.direct.athenahealth.com

Organizations & group practices 2

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": "1164672000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1656374400000",
    "number": "1255407391",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 412503",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "022412503",
            "telephone_number": "617-726-3884"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19 OLD ROLLINSFORD RD BLDG B",
            "city": "DOVER",
            "state": "NH",
            "postal_code": "038202807",
            "telephone_number": "603-516-4265"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3235 Mill Vista Rd",
            "address_purpose": "LOCATION",
            "city": "Highlands Ranch",
            "state": "CO",
            "postal_code": "801292440",
            "country_code": "US",
            "telephone_number": "303-876-8320",
            "fax_number": "303-876-8325",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MOXHAM-FISHER",
        "first_name": "PATRICIA",
        "middle_name": "A",
        "credential": "ANP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-28",
        "last_updated": "2022-06-28",
        "certification_date": "2022-06-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "CO",
            "license": "5105",
            "primary": false
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "NH",
            "license": "086609-23",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3131522",
            "state": "NH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dover, NH

Sources for this page

Verify at the official NPI Registry.