NPIMap

Individual provider Active NPI

Jacob Fisher, DO

  • Family Medicine Physician
  • Guthrie, OK
National Provider Identifier
1609220342
Registry record updated Oct 18, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
6163 Issued in OK
Practice address
205 S Academy Rd
Guthrie, OK 73044-8727
Phone
(405) 282-9449
Fax
(405) 282-9403
NPI assigned
Apr 19, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 18, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 6163 OK Primary

Addresses

Primary practice location

205 S Academy Rd
Guthrie, OK 73044-8727

Mailing address

205 S Academy Rd
Guthrie, OK 73044-8727
Phone (405) 282-9449

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20171030002789 OK Practitioner - Family Practice 3779859129 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Oklahoma State University College of Osteopathic Medicine, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Mercy Clinic Oklahoma Communities 645 clinicians

Practice addresses (Care Compare)

205 S Academy Rd
Mercy Clinic
Guthrie, OK 73044-8727
Phone (405) 282-9499

Hospital & facility affiliations

  • Companion Home Health, LLC Home health agency, Guthrie, OK, CCN 377683
  • Mercy Hospital Logan County Hospital, Guthrie, OK, CCN 371317
  • Mercy Hospital Oklahoma City, Inc Hospital, Oklahoma City, OK, CCN 370013
  • O U Medical Center Hospital, Oklahoma City, OK, CCN 370093

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
6163OKMDAudiologist

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Hospital Logan County Inc Current Accepting new patients
Mercy Clinic Oklahoma Communities Family Medicine CurrentSince Sep 16, 2019 Accepting new patients
Mercy Hospital Logan County, Inc CurrentSince Sep 16, 2019 Accepting new patients
St. John Physicians, Inc. Family Medicine CurrentSince Nov 1, 2017 Accepting new patients
Mercy Hospital Logan County, Inc CurrentSince Sep 16, 2019 Accepting new patients
St. John Physicians, Inc CurrentSince Nov 1, 2017 Accepting new patients
St John Urgent Care Clinics Inc Past Accepting new patients
Summit Medical Center Past Accepting new patients
Mercy Hospital Oklahoma City, Inc Past Accepting new patients
Mercy Hospital Oklahoma City, Inc Past Accepting new patients

Locations

400 S Grand St
Crescent, OK 73028
Phone (405) 282-6700

205 S Academy Rd
Guthrie, OK 73044
Phone (405) 282-9400

200 S Academy Rd
Guthrie, OK 73044
Phone (405) 260-4165

4300 W Memorial Rd
Oklahoma City, OK 73120
Phone (405) 752-3962

4300 McAuley Blvd
Oklahoma City, OK 73120
Phone (405) 936-5455

1705 E 19th St
Ste 302
Tulsa, OK 74104
Phone (918) 748-7585

7501 Riverside Pkwy
Tulsa, OK 74136
Phone (918) 710-4200

Interoperability endpoints

  • Direct secure messaging: jfisher1035285@directc.mercy.net

Organizations & group practices 11

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.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1461024000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1571356800000",
    "number": "1609220342",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "205 S ACADEMY RD",
            "city": "GUTHRIE",
            "state": "OK",
            "postal_code": "730448727",
            "telephone_number": "405-282-9449",
            "fax_number": "405-282-9403"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "205 S ACADEMY RD",
            "city": "GUTHRIE",
            "state": "OK",
            "postal_code": "730448727",
            "telephone_number": "405-282-9449",
            "fax_number": "405-282-9403"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FISHER",
        "first_name": "JACOB",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-04-19",
        "last_updated": "2019-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OK",
            "license": "6163",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Guthrie, OK

Sources for this page

Verify at the official NPI Registry.