Individual provider Active NPI

Andrea J Fisher, APRN, FNP-C

  • Family Nurse Practitioner
  • Jacksonville, FL
National Provider Identifier
1447612601
Registry record updated Jul 28, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
2015042085 Issued in MO
Practice address
10151 Deerwood Park Blvd Ste 100
Jacksonville, FL 32256-0566
Phone
(800) 835-2362
Fax
(666) 784-2818
NPI assigned
Mar 25, 2016
Last updated
Jul 28, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 28, 2026

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

Specialties & licenses 14

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X CNP241050 ME
Family Nurse Practitioner 363LF0000X NP500016675 DC
Family Nurse Practitioner 363LF0000X C-APN.0101735-C-NP CO
Family Nurse Practitioner 363LF0000X 2015042085 MO Primary
Family Nurse Practitioner 363LF0000X APRN11031179 FL
Family Nurse Practitioner 363LF0000X A177861 IA
Family Nurse Practitioner 363LF0000X LG-0012657 DE
Family Nurse Practitioner 363LF0000X 209029828 IL
Family Nurse Practitioner 363LF0000X 306329 AZ
Family Nurse Practitioner 363LF0000X 219309 AK
Family Nurse Practitioner 363LF0000X APRN-4489 HI
Family Nurse Practitioner 363LF0000X 53-82883-082 KS
Family Nurse Practitioner 363LF0000X 78685 ID
Family Nurse Practitioner 363LF0000X AC006363 MD

Addresses

Primary practice location

10151 Deerwood Park Blvd Ste 100
Jacksonville, FL 32256-0566

Mailing address

1487 Black Rock LN
Farmington, MO 63640-7831
Phone (573) 330-2822

Other identifiers 14

IdentifierTypeStateIssuer
101.0136841OtherVTSTATE LICENSE
13744780-4405OtherUTSTATE LICENSE
875106OtherNVSTATE LICENSE
R55573OtherNDSTATE LICENSE
53811OtherWYSTATE LICENSE
0024189313OtherVASTATE LICENSE
77490OtherNMSTATE LICENSE
10021708OtherORSTATE LICENSE
115207OtherNESTATE LICENSE
AP61517963OtherWASTATE LICENSE
APRN-235559OtherMTSTATE LICENSE
11367OtherMNNP STATE LICENSE
APRN04007OtherRISTATE LICENSE
CP003126OtherSDSTATE LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
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
I20160920001414 MO Practitioner - Nurse Practitioner 6709173776 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
219309AKMDFamily Nurse Practitioner
306329AZMDFamily Nurse Practitioner
C-APN.0101735-C-NPCOMDFamily Nurse Practitioner
NP500016675DCMDFamily Nurse Practitioner
LG-0012657DEMDFamily Nurse Practitioner
APRN11031179FLMDFamily Nurse Practitioner
100243GUMDFamily Nurse Practitioner
APRN-4489HIMDFamily Nurse Practitioner
A177861IAMDFamily Nurse Practitioner
78685IDMDFamily Nurse Practitioner
209029828ILMDFamily Nurse Practitioner
53-82883-082KSMDFamily Nurse Practitioner
AC006363MDMDFamily Nurse Practitioner
CNP241050MEMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Parkland Health Center CurrentSince Jan 1, 2023 Accepting new patients
Parkland Health Center CurrentSince Jan 1, 2023 Accepting new patients
Ozarks Medical Center Past Accepting new patients

Locations

1101 W Liberty St
Farmington, MO 63640
Phone (573) 705-1272

1103 W Liberty St
Farmington, MO 63640
Phone (573) 760-8488

1103 W Liberty St
#3002
Farmington, MO 63640

Interoperability endpoints

  • Direct secure messaging: andrea.fisher.1@33201.direct.athenahealth.com
  • FHIR API: https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1458864000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1785196800000",
    "number": "1447612601",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1487 BLACK ROCK LN",
            "city": "FARMINGTON",
            "state": "MO",
            "postal_code": "636407831",
            "telephone_number": "573-330-2822",
            "fax_number": "866-678-4281"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10151 DEERWOOD PARK BLVD STE 100",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322560566",
            "telephone_number": "800-835-2362",
            "fax_number": "666-784-2818"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FISHER",
        "first_name": "ANDREA",
        "middle_name": "J",
        "credential": "APRN, FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-03-25",
        "last_updated": "2026-07-28",
        "certification_date": "2026-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "ME",
            "license": "CNP241050",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "DC",
            "license": "NP500016675",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CO",
            "license": "C-APN.0101735-C-NP",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MO",
            "license": "2015042085",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "APRN11031179",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IA",
            "license": "A177861",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "DE",
            "license": "LG-0012657",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209029828",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AZ",
            "license": "306329",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AK",
            "license": "219309",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "HI",
            "license": "APRN-4489",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "KS",
            "license": "53-82883-082",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "ID",
            "license": "78685",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MD",
            "license": "AC006363",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "101.0136841",
            "state": "VT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "13744780-4405",
            "state": "UT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "875106",
            "state": "NV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "R55573",
            "state": "ND"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "53811",
            "state": "WY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "0024189313",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "77490",
            "state": "NM"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "10021708",
            "state": "OR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "115207",
            "state": "NE"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "AP61517963",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "APRN-235559",
            "state": "MT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NP STATE LICENSE",
            "identifier": "11367",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "APRN04007",
            "state": "RI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "CP003126",
            "state": "SD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

Verify at the official NPI Registry.