Individual provider Active NPI

Mark Thomas Fisher, MD

  • Pediatric Rehabilitation Medicine Physician
  • Kansas City, MO
National Provider Identifier
1598007254
Registry record updated May 21, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Rehabilitation Medicine PhysicianTaxonomy code 2081P0010X
License
2017014405 Issued in MO
Practice address
2401 Gillham Rd
Kansas City, MO 64108-4619
Phone
(816) 234-3000
NPI assigned
Mar 20, 2013
Last updated
May 21, 2019By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 21, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Rehabilitation Medicine Physician 2081P0010X 2017014405 MO Primary

Addresses

Primary practice location

2401 Gillham Rd
Kansas City, MO 64108-4619

Mailing address

2401 Gillham Rd Ste 140
Kansas City, MO 64108-4619

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KS, MO2 enrollments
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.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20200325003221 KS Practitioner - Physical Medicine and Rehabilitation 9739322959 Reassigns benefits to 1 organization
I20200326000293 MO Practitioner - Physical Medicine and Rehabilitation 9739322959 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
2017014405MOMDPediatric Rehabilitation Medicine Physician
MD-41973IAMDPlastic and Reconstructive Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The Children's Mercy Hospital CurrentSince Mar 12, 2020 Accepting new patients
The Children's Mercy Hospital CurrentSince Mar 12, 2020 Accepting new patients
The Children's Mercy Hospital Past Accepting new patients
Ozarks Medical Center Past Accepting new patients

Locations

1801 N 98th St
Kansas City, KS 66111
Phone (913) 264-3000

5808 W 110th St
Overland Park, KS 66211
Phone (913) 696-8000

5520 College Blvd
Shawnee Msn, KS 66211
Phone (913) 491-3040

2401 Gillham Rd
Kansas City, MO 64108
Phone (816) 234-3380

2401 Gillham Rd
Ste 140
Kansas City, MO 64108

501 NW Barry Rd
Kansas City, MO 64155
Phone (816) 413-2500

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": "1363737600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1558396800000",
    "number": "1598007254",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2401 GILLHAM RD STE 140",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641084619"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2401 GILLHAM RD",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641084619",
            "telephone_number": "816-234-3000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FISHER",
        "first_name": "MARK",
        "middle_name": "THOMAS",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-03-20",
        "last_updated": "2019-05-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2081P0010X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation, Pediatric Rehabilitation Medicine",
            "state": "MO",
            "license": "2017014405",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kansas City, MO

Sources for this page

Verify at the official NPI Registry.