Individual provider Active NPI

Jessica P Fisher

  • Nurse Practitioner
  • Middletown, RI
National Provider Identifier
1336893700
Registry record updated Sep 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
APRN03640 Issued in RI
Practice address
672 Aquidneck Ave
Middletown, RI 02842-5795
Phone
(401) 847-0159
Fax
(401) 846-0283
NPI assigned
Feb 4, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 1, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X APRN03640 RI Primary

Addresses

Primary practice location

672 Aquidneck Ave
Middletown, RI 02842-5795

Mailing address

200 Mill Rd
Fairhaven, MA 02719-5252
Phone (508) 973-2000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in RI
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
I20240722000033 RI Practitioner - Nurse Practitioner 7315483831 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Southcoast Physicians Group IncGroup PAC ID 0749171957, 875 clinicians

Practice addresses (Care Compare)

672 Aquidneck Ave
Middletown, RI 02842-5795
Phone (401) 847-0519

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
APRN03640RIMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Southcoast Physicians Group, Inc. CurrentSince Jun 11, 2024 Accepting new patients
Southcoast Physicians Group, Inc. CurrentSince Jun 11, 2024 Accepting new patients

Locations

363 Highland Ave
Fall River, MA 02720
Phone (508) 679-7052

672 Aquidneck Ave
Middletown, RI 02842
Phone (401) 847-0519

11 Friendship St
Newport, RI 02840
Phone (401) 845-1110

Interoperability endpoints

  • Direct secure messaging: jfisher78711@direct.southcoast.org

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 and National Provider Directory roles.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1643932800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725148800000",
    "number": "1336893700",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 MILL RD",
            "city": "FAIRHAVEN",
            "state": "MA",
            "postal_code": "027195252",
            "telephone_number": "508-973-2000",
            "fax_number": "508-973-2001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "672 AQUIDNECK AVE",
            "city": "MIDDLETOWN",
            "state": "RI",
            "postal_code": "028425795",
            "telephone_number": "401-847-0159",
            "fax_number": "401-846-0283"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FISHER",
        "first_name": "JESSICA",
        "middle_name": "P",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-02-04",
        "last_updated": "2024-09-01",
        "certification_date": "2024-09-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "RI",
            "license": "APRN03640",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Middletown, RI

Sources for this page

Verify at the official NPI Registry.