Active NPI
Mary Allison Fischer, D.O.
- Family Medicine Physician
- Sedalia, MO
National Provider Identifier
1376615054
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- R5C49
- Practice address
- 1123 E Broadway Blvd
Sedalia, MO 65301-6103 - Phone
- (660) 826-2797
- Fax
- (660) 826-2365
- NPI assigned
- Nov 15, 2006
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | R5C49 | MO | Primary |
Addresses
Primary practice location
1123 E Broadway Blvd
Sedalia, MO 65301-6103
Mailing address
1123 E Broadway Blvd
Sedalia, MO 65301-6103
Phone (660) 826-2797
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 15322 | Other | ALLIANCE | |
| C52251 | Other | MERCY HEALTH PLANS | |
| 13753027 | Other | MO | BLUECROSS |
| 107921 | Other | HEALTHLINK |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
- Opted out of Medicare
- Yes, effective Jan 1, 2016 through Jan 1, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| R5C49 | MO | MD | Family Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1163548800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1376615054",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1123 E BROADWAY BLVD",
"city": "SEDALIA",
"state": "MO",
"postal_code": "653016103",
"telephone_number": "660-826-2797",
"fax_number": "660-826-2365"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1123 E BROADWAY BLVD",
"city": "SEDALIA",
"state": "MO",
"postal_code": "653016103",
"telephone_number": "660-826-2797",
"fax_number": "660-826-2365"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FISCHER",
"first_name": "MARY",
"middle_name": "ALLISON",
"credential": "D.O.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-11-15",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "MO",
"license": "R5C49",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ALLIANCE",
"identifier": "15322",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MERCY HEALTH PLANS",
"identifier": "C52251",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUECROSS",
"identifier": "13753027",
"state": "MO"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HEALTHLINK",
"identifier": "107921",
"state": null
}
],
"endpoints": [],
"other_names": []
}Other providers in Sedalia, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.