Individual provider Active NPI

Carissa Ann Fisher, CRNA

  • Certified Registered Nurse Anesthetist
  • Omaha, NE
National Provider Identifier
1629383245
Registry record updated Dec 12, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
108117 Issued in NE
Practice address
8303 Dodge Street
Omaha, NE 68114
Phone
(402) 354-4000
NPI assigned
Aug 9, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 12, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 60684 NE
Certified Registered Nurse Anesthetist 367500000X 108117 NE Primary

Addresses

Primary practice location

8303 Dodge Street
Omaha, NE 68114

Mailing address

7822 Davenport Street
Omaha, NE 68114-3629
Phone (402) 391-4855

Other identifiers 1

IdentifierTypeStateIssuer
60684OtherNENE RN LICENSE

Other names 1

  • Carissa Ann Daly Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NE

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120208000876 NE Practitioner - Certified Registered Nurse Anesthetist (Crna) 2769649383 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Midwest Gastrointestinal Associates PCGroup PAC ID 3779575766, 54 clinicians

Practice addresses (Care Compare)

8901 Indian Hills Dr
Suite 200
Omaha, NE 68114-4032
Phone (402) 397-7057

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
60684NEMDRegistered Nurse
108117NEMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Midwest Gastrointestinal Associates PC Nurse Anesthetist, Certified Registered CurrentSince Mar 20, 2015 Accepting new patients
Diagnostic & Int Med Assoc PC Past Accepting new patients
Anesthesia West, P.C. Past Accepting new patients
Anesthesia Services of Omaha LLC Past Accepting new patients

Locations

17001 Lakeside Hills Plz
Ste 200
Omaha, NE 68130
Phone (402) 885-8700

7822 Davenport St
Omaha, NE 68114
Phone (402) 391-4855

8901 Indian Hills Dr
Ste 200
Omaha, NE 68114
Phone (402) 397-7057

7500 Mercy Rd
Omaha, NE 68124
Phone (402) 398-5880

16901 Lakeside Hills Ct
Omaha, NE 68130
Phone (402) 572-6500

8303 W Dodge Rd
Omaha, NE 68114
Phone (402) 354-4000

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1281312000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1323648000000",
    "number": "1629383245",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7822 DAVENPORT STREET",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681143629",
            "telephone_number": "402-391-4855",
            "fax_number": "402-391-6818"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8303 DODGE STREET",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "68114",
            "telephone_number": "402-354-4000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FISHER",
        "first_name": "CARISSA",
        "middle_name": "ANN",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-08-09",
        "last_updated": "2011-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NE",
            "license": "60684",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "NE",
            "license": "108117",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NE RN LICENSE",
            "identifier": "60684",
            "state": "NE"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CARISSA",
            "last_name": "DALY",
            "middle_name": "ANN",
            "credential": "RN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Omaha, NE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.