Active NPI
Pamela Fisher
- In Home Supportive Care Agency
- Brandon, FL
National Provider Identifier
1689110363
On this page
Key facts
NPPES NPI Registry- Primary specialty
- In Home Supportive Care Agency
- License
- 623738
- Practice address
- 509 Hickory Lake Dr
Brandon, FL 33511-6337 - Phone
- (813) 304-5794
- NPI assigned
- Jan 18, 2017
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| In Home Supportive Care Agency | 253Z00000X | 623738 | FL | Primary |
Addresses
Primary practice location
509 Hickory Lake Dr
Brandon, FL 33511-6337
Mailing address
509 Hickory Lake Dr
Brandon, FL 33511-6337
Phone (813) 304-5794
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 623738 | Other | ATN |
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 623738 | FL | MD | In Home Supportive Care Agency |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1484697600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1484697600000",
"number": "1689110363",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "509 HICKORY LAKE DR",
"city": "BRANDON",
"state": "FL",
"postal_code": "335116337",
"telephone_number": "813-304-5794"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "509 HICKORY LAKE DR",
"city": "BRANDON",
"state": "FL",
"postal_code": "335116337",
"telephone_number": "813-304-5794"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FISHER",
"first_name": "PAMELA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2017-01-18",
"last_updated": "2017-01-18",
"status": "A"
},
"taxonomies": [
{
"code": "253Z00000X",
"taxonomy_group": "",
"desc": "In Home Supportive Care",
"state": "FL",
"license": "623738",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ATN",
"identifier": "623738",
"state": null
}
],
"endpoints": [],
"other_names": []
}Other providers in Brandon, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.