Individual provider Active NPI

Rene Nicole Fisler, AGNP-C

  • Family Nurse Practitioner
  • Brunswick, GA
National Provider Identifier
1700399060
Registry record updated Jan 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APRN9291781 Issued in FL
Practice address
2415 Parkwood Dr
Brunswick, GA 31520-4722
Phone
(912) 466-7188
NPI assigned
Nov 8, 2017
Last updated
Jan 22, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 22, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X RN190618 GA
Family Nurse Practitioner 363LF0000X APRN9291781 FL Primary

Addresses

Primary practice location

2415 Parkwood Dr
Brunswick, GA 31520-4722

Mailing address

131 Thrift Rd
Woodbine, GA 31569-2430
Phone (912) 552-0251

Other identifiers 1

IdentifierTypeStateIssuer
RN190618OtherGALICENSE NUMBER

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA, FL2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20180207001602 GA Practitioner - Nurse Practitioner 1658631890 Reassigns benefits to 4 organizations
I20200214000146 FL Practitioner - Nurse Practitioner 1658631890 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1900 Tebeau St
Waycross, GA 31501-6357
Phone (912) 283-3030

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
RN190618GAMDAdult Health Nurse Practitioner
APRN9291781FLMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Cooperative Healthcare Services Inc CurrentSince Dec 15, 2017 Accepting new patients
Cogent Healthcare of Georgia PC CurrentSince Jan 1, 2023 Accepting new patients
Hni Medical Services of Florida, LLC CurrentSince Dec 23, 2019 Accepting new patients
Hospital Physician Services - Southeast Professional Corporation CurrentSince Sep 18, 2020 Accepting new patients

Locations

1 Shircliff Way
Jacksonville, FL 32204
Phone (904) 332-0414

4201 Belfort Rd
Jacksonville, FL 32216
Phone (904) 268-5561

2415 Parkwood Dr
Brunswick, GA 31520
Phone (912) 466-4079

1170 Cleveland Ave
East Point, GA 30344
Phone (404) 305-3500

501 Redmond Rd NW
Rome, GA 30165
Phone (706) 291-0291

4700 Waters Ave
Savannah, GA 31404
Phone (912) 273-1100

1900 Tebeau St
Waycross, GA 31501
Phone (912) 283-3030

7500 Rialto Blvd
Ste 1-140
Austin, TX 78735

Organizations & group practices 5

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1510099200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1579651200000",
    "number": "1700399060",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "131 THRIFT RD",
            "city": "WOODBINE",
            "state": "GA",
            "postal_code": "315692430",
            "telephone_number": "912-552-0251"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2415 PARKWOOD DR",
            "city": "BRUNSWICK",
            "state": "GA",
            "postal_code": "315204722",
            "telephone_number": "912-466-7188"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FISLER",
        "first_name": "RENE",
        "middle_name": "NICOLE",
        "credential": "AGNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-11-08",
        "last_updated": "2020-01-22",
        "certification_date": "2020-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "GA",
            "license": "RN190618",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "APRN9291781",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE NUMBER",
            "identifier": "RN190618",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brunswick, GA

Sources for this page

Verify at the official NPI Registry.