Stephan Ryan Fisher, ATC, LAT

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

License

AT6772 Issued in TX

Practice address

222 Bartlett Dr
El Paso, TX 79912-1608

Phone

(719) 323-5332

NPI assigned

Nov 3, 2017

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1509667200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639440000000",
    "number": "1407368111",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10348 ROSS LAKE DR",
            "city": "PEYTON",
            "state": "CO",
            "postal_code": "808318439",
            "telephone_number": "719-323-5332"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "222 BARTLETT DR",
            "city": "EL PASO",
            "state": "TX",
            "postal_code": "799121608",
            "telephone_number": "719-323-5332"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FISHER",
        "first_name": "STEPHAN",
        "middle_name": "RYAN",
        "name_prefix": "Mr.",
        "credential": "ATC, LAT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-11-03",
        "last_updated": "2021-12-14",
        "certification_date": "2021-12-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": null,
            "license": "2000025610",
            "primary": false
        },
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "TX",
            "license": "AT6772",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Erica Grace Fischer
• Kaye Colyce Fischer, BSN, RN, CDE
• Daleth Edrei Fisher, NP
• Danielle Croslin Fisher, PMHNP-BC
• Lucia Claudia Fisher, FNP
• Ji Soo Chung Fishman, REGISTERED NURSE
• Haydee Fiske, FNP
• Tamara Noel Fitzgerald, M.D.
• Kelly Vaughn Fitzpatrick, D.O.
• Priscilla Iris Fitzpatrick, RBT

• Athletic Trainer in El Paso, TX
• Providers in El Paso, TX by specialty
• Athletic Trainer in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 14, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.