Elizabeth Kern Fisher, MA, CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

SA16797 Issued in FL

Practice address

888 Bonita Ave
New Smyrna Beach, FL 32169-4624

Phone

(407) 757-6333

NPI assigned

Jun 29, 2017

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

State licenses

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

{
    "created_epoch": "1498694400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1628985600000",
    "number": "1629599667",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "888 BONITA AVE",
            "city": "NEW SMYRNA BEACH",
            "state": "FL",
            "postal_code": "321694624",
            "telephone_number": "407-757-6333"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "888 BONITA AVE",
            "city": "NEW SMYRNA BEACH",
            "state": "FL",
            "postal_code": "321694624",
            "telephone_number": "407-757-6333"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FISHER",
        "first_name": "ELIZABETH",
        "middle_name": "KERN",
        "credential": "MA, CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-06-29",
        "last_updated": "2021-08-15",
        "certification_date": "2021-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "FL",
            "license": "SA16797",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "022227600",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DEPARTMENT OF HEALTH",
            "identifier": "SA16797",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Speech-Language Pathologist in New Smyrna Beach, FL
• Providers in New Smyrna Beach, FL by specialty
• Speech-Language Pathologist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.