Active NPI
John G. Fisher, M.D.
- Child & Adolescent Psychiatry Physician
- Lynchburg, VA
National Provider Identifier
1487654364
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Child & Adolescent Psychiatry Physician
- License
- 0101043246
- Practice address
- 3300 Rivermont Ave
Lynchburg, VA 24503-2030 - Phone
- (434) 200-5999
- NPI assigned
- Jul 21, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | 0101043246 | VA | |
| Child & Adolescent Psychiatry Physician | 2084P0804X | 0101043246 | VA | Primary |
Addresses
Primary practice location
3300 Rivermont Ave
Lynchburg, VA 24503-2030
Mailing address
1204 Fenwick Dr
Lynchburg, VA 24502-2112
Other identifiers 5
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 179467 | Other | VALUE OPTIONS PROVIDER NU | |
| 203639329001 | Other | TRICARE PROVIDER NUMBER | |
| 2016145 | Other | CIGNA BEHAVIOR PROVIDER N | |
| 186460 | Other | ANTHEM PROVIDER NUMBER | |
| O87281 | Other | SENTARA/OPTIMA PROVIDER N |
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
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0101043246 | VA | MD | Child & Adolescent Psychiatry Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1121904000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1205280000000",
"number": "1487654364",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1204 FENWICK DR",
"city": "LYNCHBURG",
"state": "VA",
"postal_code": "245022112"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3300 RIVERMONT AVE",
"city": "LYNCHBURG",
"state": "VA",
"postal_code": "245032030",
"telephone_number": "434-200-5999"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FISHER",
"first_name": "JOHN",
"middle_name": "G.",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-07-21",
"last_updated": "2008-03-12",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "VA",
"license": "0101043246",
"primary": false
},
{
"code": "2084P0804X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
"state": "VA",
"license": "0101043246",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "VALUE OPTIONS PROVIDER NU",
"identifier": "179467",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TRICARE PROVIDER NUMBER",
"identifier": "203639329001",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CIGNA BEHAVIOR PROVIDER N",
"identifier": "2016145",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ANTHEM PROVIDER NUMBER",
"identifier": "186460",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "SENTARA/OPTIMA PROVIDER N",
"identifier": "O87281",
"state": null
}
],
"endpoints": [],
"other_names": []
}Other providers in Lynchburg, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.