Individual provider Active NPI

Cynthia Mildred Fisher, NP

  • Nurse Practitioner
  • Sheboygan, WI
National Provider Identifier
1457390510
Registry record updated Sep 11, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
3016 Issued in WI
Practice address
3100 Superior Ave
Sheboygan, WI 53081-1948
Phone
(920) 459-5176
NPI assigned
Jun 5, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2007

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X 4704219595 MI
Nurse Practitioner 363L00000X 3016 WI Primary

Addresses

Primary practice location

3100 Superior Ave
Sheboygan, WI 53081-1948

Mailing address

3519 Saemann Ave Apt 1
Sheboygan, WI 53081-1890
Phone (920) 452-0887

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
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
I20070309000461 WI Practitioner - Nurse Practitioner 2163525262 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4704219595MIMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Apogee Medical Group, Wisconsin, S.C CurrentSince Aug 15, 2018 Accepting new patients
Sharon S. Richardson Hospice Home, Inc Past Accepting new patients
Sheboygan Cancer & Blood Specialists, SC Past Accepting new patients

Locations

744 S Webster Ave
Green Bay, WI 54301
Phone (920) 433-6025

125 Hospital Dr
Watertown, WI 53098
Phone (920) 261-4210

Organizations & group practices 3

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

NPI Registry JSON

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

{
    "created_epoch": "1149465600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1189468800000",
    "number": "1457390510",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3519 SAEMANN AVE APT 1",
            "city": "SHEBOYGAN",
            "state": "WI",
            "postal_code": "530811890",
            "telephone_number": "920-452-0887"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3100 SUPERIOR AVE",
            "city": "SHEBOYGAN",
            "state": "WI",
            "postal_code": "530811948",
            "telephone_number": "920-459-5176"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FISHER",
        "first_name": "CYNTHIA",
        "middle_name": "MILDRED",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-05",
        "last_updated": "2007-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "MI",
            "license": "4704219595",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "WI",
            "license": "3016",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sheboygan, WI

Sources for this page

Verify at the official NPI Registry.