Individual provider Active NPI

Justin Kenneth Fisher

  • Student in an Organized Health Care Education/Training Program
  • Overland Park, KS
National Provider Identifier
1326849670
Registry record updated Mar 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
10500 Quivira Rd
Overland Park, KS 66215-2306
Phone
(913) 541-6022
NPI assigned
Mar 22, 2025
Last updated
Mar 22, 2025By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 22, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X Primary

Addresses

Primary practice location

10500 Quivira Rd
Overland Park, KS 66215-2306

Mailing address

10500 Quivira Rd
Overland Park, KS 66215-2306
Phone (913) 541-6022

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KS
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250814003240 KS Order and Referring Only - Internal MedicinePractitioner - Internal Medicine 4486153772

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Interoperability endpoints

  • Direct secure messaging: justin.fisher@hca2.eclinicaldirectplus.com

NPI Registry JSON

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

{
    "created_epoch": "1742601600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742601600000",
    "number": "1326849670",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10500 QUIVIRA RD",
            "city": "OVERLAND PARK",
            "state": "KS",
            "postal_code": "662152306",
            "telephone_number": "913-541-6022"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10500 QUIVIRA RD",
            "city": "OVERLAND PARK",
            "state": "KS",
            "postal_code": "662152306",
            "telephone_number": "913-541-6022"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FISHER",
        "first_name": "JUSTIN",
        "middle_name": "KENNETH",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2025-03-22",
        "last_updated": "2025-03-22",
        "certification_date": "2025-03-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Overland Park, KS

Sources for this page

Verify at the official NPI Registry.