Active NPI
Judith A Fisher, DO
- Psychiatry Physician
- Fulton, MO
National Provider Identifier
1619988953
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- R4C25
- Practice address
- 600 E 5TH St
Fulton State Hospital
Fulton, MO 65251-1753 - Phone
- (573) 592-4100
- Fax
- (573) 592-3023
- NPI assigned
- Aug 11, 2006
- Last updated
- Jun 20, 2008
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | R4C25 | MO | Primary |
Addresses
Primary practice location
600 E 5TH St
Fulton State Hospital
Fulton, MO 65251-1753
Mailing address
600 E 5TH St
Fulton, MO 65251-1753
Phone (573) 592-4100
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 241712017 | Medicaid | MO |
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 Osteopathy, Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| R4C25 | MO | MD | Psychiatry Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1155254400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1213920000000",
"number": "1619988953",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "600 E 5TH ST",
"city": "FULTON",
"state": "MO",
"postal_code": "652511753",
"telephone_number": "573-592-4100",
"fax_number": "573-592-3023"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "600 E 5TH ST",
"address_2": "FULTON STATE HOSPITAL",
"city": "FULTON",
"state": "MO",
"postal_code": "652511753",
"telephone_number": "573-592-4100",
"fax_number": "573-592-3023"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FISHER",
"first_name": "JUDITH",
"middle_name": "A",
"credential": "DO",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-08-11",
"last_updated": "2008-06-20",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "MO",
"license": "R4C25",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "241712017",
"state": "MO"
}
],
"endpoints": [],
"other_names": []
}Other providers in Fulton, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 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.