Active NPI
Brenda Sue Fisher, PA-C
- Medical Physician Assistant
- Calhoun, GA
National Provider Identifier
1447360375
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Medical Physician Assistant
- License
- 002915
- Practice address
- 1035 Red Bud Rd NE
Calhoun, GA 30701-6010 - Phone
- (706) 879-4776
- Fax
- (706) 879-4781
- NPI assigned
- Aug 30, 2006
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Medical Physician Assistant | 363AM0700X | 002915 | GA | Primary |
Addresses
Primary practice location
1035 Red Bud Rd NE
Calhoun, GA 30701-6010
Mailing address
PO Box 12938
C/O Clinic Management
Calhoun, GA 30703
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 003106685B | Medicaid | GA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 002915 | GA | MD | Medical Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156896000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1545264000000",
"number": "1447360375",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 12938",
"address_2": "C/O CLINIC MANAGEMENT",
"city": "CALHOUN",
"state": "GA",
"postal_code": "30703"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1035 RED BUD RD NE",
"city": "CALHOUN",
"state": "GA",
"postal_code": "307016010",
"telephone_number": "706-879-4776",
"fax_number": "706-879-4781"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FISHER",
"first_name": "BRENDA",
"middle_name": "SUE",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-08-30",
"last_updated": "2018-12-20",
"status": "A"
},
"taxonomies": [
{
"code": "363AM0700X",
"taxonomy_group": "",
"desc": "Physician Assistant, Medical",
"state": "GA",
"license": "002915",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "003106685B",
"state": "GA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Calhoun, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.