Individual provider Active NPI

Allen Craig Fisher, D.O.

  • Family Medicine Physician
  • Glen Burnie, MD
National Provider Identifier
1407921372
Registry record updated Jan 10, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
H0052510 Issued in MD
Practice address
1414 Crain Hwy N Ste 5a
Glen Burnie, MD 21061-9307
Phone
(410) 766-7016
NPI assigned
Nov 22, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 10, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X H0052510 MD Primary

Addresses

Primary practice location

1414 Crain Hwy N Ste 5a
Glen Burnie, MD 21061-9307

Mailing address

1414 Crain Hwy N Ste 5a
Glen Burnie, MD 21061-9307
Phone (410) 766-7016

Other identifiers 8

IdentifierTypeStateIssuer
0100775OtherUNITED HEALTHCARE
2330992OtherAETNA HMO
280964OtherALLIANCE
P13753OtherCAREFIRST POS
7729015OtherAETNA PPO, EPO
OF24ACOtherCAREFIRST BCBS
1138450OtherFIRST HEALTH
W4870001OtherBLUE CHOICE AND FEP

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
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
I20070102000452 MD Practitioner - Family Practice 9436159118 Practice locations: Glen Burnie, MD

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Kansas City University of Med & Biosciences, College of Osteo Med, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1414 Crain Hwy N
Suite 5a
Glen Burnie, MD 21061-9307

1414 Crain N Hwy 5a
Glen Burnie, MD 21061-9307
Phone (410) 766-7016

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
H0052510MDMDFamily Medicine Physician

Interoperability endpoints

  • Direct secure messaging: afisher42771@direct.umm.edu

NPI Registry JSON

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

{
    "created_epoch": "1164153600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1199923200000",
    "number": "1407921372",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1414 CRAIN HWY N STE 5A",
            "city": "GLEN BURNIE",
            "state": "MD",
            "postal_code": "210619307",
            "telephone_number": "410-766-7016"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1414 CRAIN HWY N STE 5A",
            "city": "GLEN BURNIE",
            "state": "MD",
            "postal_code": "210619307",
            "telephone_number": "410-766-7016"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FISHER",
        "first_name": "ALLEN",
        "middle_name": "CRAIG",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-22",
        "last_updated": "2008-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MD",
            "license": "H0052510",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE",
            "identifier": "0100775",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA HMO",
            "identifier": "2330992",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ALLIANCE",
            "identifier": "280964",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAREFIRST POS",
            "identifier": "P13753",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA PPO, EPO",
            "identifier": "7729015",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAREFIRST BCBS",
            "identifier": "OF24AC",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FIRST HEALTH",
            "identifier": "1138450",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CHOICE AND FEP",
            "identifier": "W4870001",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Glen Burnie, MD

Sources for this page

Verify at the official NPI Registry.