NPIMap

Organization Active NPI

Bruce D Fisher DPM PC

Doing business as Advanced Foot and Ankle Center of MT

  • Foot & Ankle Surgery Podiatrist
  • Great Falls, MT
National Provider Identifier
1285795047
Registry record updated Jun 21, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
145 Issued in MT
Legal business name
BRUCE D FISHER DPM PC
Doing business as
Advanced Foot and Ankle Center of MT
Practice address
1016 9TH St S
Great Falls, MT 59405-4401
Phone
(406) 727-7771
Fax
(406) 771-6575
NPI assigned
Dec 13, 2006
Last updated
Jun 21, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 21, 2018

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

Authorized official

Name
Bruce D Fisher, DPMNPI 1417920521
Title
President
Phone
(406) 727-7771

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X
Foot & Ankle Surgery Podiatrist 213ES0103X 145 MT Primary

Addresses

Primary practice location

1016 9TH St S
Great Falls, MT 59405-4401

Mailing address

1016 9TH St S
Great Falls, MT 59405-4401
Phone (406) 727-7771

Other identifiers 2

IdentifierTypeStateIssuer
000095326OtherMTBCBS OF MT
0390898MedicaidMT

Other names 1

  • Advanced Foot and Ankle Center of MT Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MT2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20061222000128 MT Part B Supplier - Clinic/Group Practice 0941200992 Receives reassigned benefits from 1 practitioner
Practice locations: Great Falls, MT
O20100930029189 MT DME Supplier - Physician - Podiatry 0941200992 Practice locations: Great Falls, MT

National Provider Directory

National Provider Directory

Locations

221 5th St S
Glasgow, MT 59230
Phone (406) 228-3400

1016 9th St S
Great Falls, MT 59405
Phone (406) 262-3462

920 13th Ave S
Great Falls, MT 59405
Phone (406) 727-7771

Practitioners & affiliated clinicians

Practitioners 26

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 26

NPI Registry JSON

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

{
    "created_epoch": "1165968000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1529539200000",
    "number": "1285795047",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1016 9TH ST S",
            "city": "GREAT FALLS",
            "state": "MT",
            "postal_code": "594054401",
            "telephone_number": "406-727-7771",
            "fax_number": "406-771-6575"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1016 9TH ST S",
            "city": "GREAT FALLS",
            "state": "MT",
            "postal_code": "594054401",
            "telephone_number": "406-727-7771",
            "fax_number": "406-771-6575"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRUCE D FISHER DPM PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-13",
        "last_updated": "2018-06-21",
        "status": "A",
        "authorized_official_last_name": "FISHER",
        "authorized_official_first_name": "BRUCE",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "406-727-7771",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "MT",
            "license": "145",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF MT",
            "identifier": "000095326",
            "state": "MT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0390898",
            "state": "MT"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Advanced Foot and Ankle Center of MT",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Great Falls, MT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.