Cary Nelson Fishburne, M.D.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

0101026966 Issued in VA

Practice address

7363 Walker Ave
Gloucester, VA 23061-6119

Phone

(804) 695-0305

Fax

(804) 695-0804

NPI assigned

Aug 23, 2005

Last updated

May 21, 2008By the provider in NPPES

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

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Children's Medical Group, Inc., D/B/a Courthouse Pediatrics

  • Pediatrics Physician
  • Gloucester, VA
  • NPI 1215940507
  NPD (past)

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

{
    "created_epoch": "1124755200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1211328000000",
    "number": "1669464988",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 800",
            "city": "GLOUCESTER",
            "state": "VA",
            "postal_code": "230610800",
            "telephone_number": "804-695-0305",
            "fax_number": "804-695-0804"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7363 WALKER AVE",
            "city": "GLOUCESTER",
            "state": "VA",
            "postal_code": "230616119",
            "telephone_number": "804-695-0305",
            "fax_number": "804-695-0804"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FISHBURNE",
        "first_name": "CARY",
        "middle_name": "NELSON",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-23",
        "last_updated": "2008-05-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "VA",
            "license": "0101026966",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "006715061",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Aashna Faizy, PA-C
• Amanda Durrette Faulkner, MS, OTR/L
• Kathryn Elise Felts, FNP-C
• Denise Ferguson, LPC
• James Fish, M.D., FACEP
• Harriette B Fishburne, M.D.
• Hannah Fleming, CSAC, NCACII, QMHP-A
• Jay Miles Forman, PA-C
• Dana Foster, RPRS
• Foundational Intervention and Therapy

• Pediatrics Physician in Gloucester, VA
• Providers in Gloucester, VA by specialty
• Pediatrics Physician in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 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.

Verify at the official NPI Registry.