Kenneth A Fisher, M.D.

Primary specialty

Nephrology PhysicianTaxonomy code 207RN0300X

License

4301062620 Issued in MI

Practice address

4335 Roxbury LN
Kalamazoo, MI 49008-3314

Phone

(269) 385-3586

NPI assigned

May 18, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Apr 1, 2016 through Apr 1, 2028

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1147910400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1268870400000",
    "number": "1548213986",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 20203",
            "city": "KALAMAZOO",
            "state": "MI",
            "postal_code": "490191203",
            "telephone_number": "269-375-7565",
            "fax_number": "269-375-7565"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4335 ROXBURY LN",
            "city": "KALAMAZOO",
            "state": "MI",
            "postal_code": "490083314",
            "telephone_number": "269-385-3586"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FISHER",
        "first_name": "KENNETH",
        "middle_name": "A",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-18",
        "last_updated": "2010-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "MI",
            "license": "4301062620",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Christopher Miles K Fish, D.O.
• Simone Fish, DO
• Nicole Fishell
• Kelly Nickole Fisher-Satterfield, LLMSW
• Joshua D Fisher, P.T.
• Kevin Fisher
• Danielle Elizabeth Fiskars-Byers, RD
• Donald Fitzgerald, LLPC
• Kateri Trelles Fitzgerald, FNP
• Kevin Fitzgerald, PMHNP-BC

• Nephrology Physician in Kalamazoo, MI
• Providers in Kalamazoo, MI by specialty
• Nephrology Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.