Shane Fisher, PT, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

2305211865 Issued in VA

Practice address

4343 W Newberry Rd
Gainesville, FL 32607-2817

Phone

(352) 373-6565

NPI assigned

May 8, 2018

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Coltman and Baughman Physical Therapy PAGroup PAC ID 6305063488, 10 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Coltman and Baughman Physical Therapy PA

  • Physical Therapy Clinic/Center
  • Jacksonville Beach, FL
  • NPI 1659781300
  Medicare reassignment Care Compare group NPD
• Coltman and Baughman Physical Therapy PA

  • Physical Therapy Clinic/Center
  • Jacksonville, FL
  • NPI 1962079467
  NPD

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

{
    "created_epoch": "1525737600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1525737600000",
    "number": "1639668304",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4455 SW 34TH ST APT Q88",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326086549",
            "telephone_number": "561-876-5800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4343 W NEWBERRY RD",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326072817",
            "telephone_number": "352-373-6565"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FISHER",
        "first_name": "SHANE",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-05-08",
        "last_updated": "2018-05-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "VA",
            "license": "2305211865",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Andrew Michael Fisher, MD
• Janeka Fisher
• Jennifer L Fisher, PHD
• Lauren Fisher
• Sarah Fisher, RBT
• Shila Fisher, PHARMD
• Tiffany Fisher, MA 100860
• Valerie Fisher
• Yoko Fisher
• David S. Fishman, M.D.

• Physical Therapist in Gainesville, FL
• Providers in Gainesville, FL by specialty
• Physical Therapist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 8, 2018; 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.