Active NPI
Jada Fisher
- Personal Care Attendant
- Atoka, OK
National Provider Identifier
1700504933
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Personal Care Attendant
- Practice address
- 1680 S Greathouse Drive
Atoka, OK 74525-7452 - Phone
- (808) 896-6115
- Fax
- (580) 324-4181
- NPI assigned
- Aug 15, 2022
- Reactivated
- Jan 17, 2023
- 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 |
|---|---|---|---|---|
| Personal Care Attendant | 3747P1801X | Primary |
Addresses
Primary practice location
1680 S Greathouse Drive
Atoka, OK 74525-7452
Mailing address
1775 S Greathouse Dr
Atoka, OK 74525-3434
Phone (580) 889-6611
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 100683770A | Medicaid | OK |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | Atoka | Other |
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1660521600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1673913600000",
"number": "1700504933",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1775 S GREATHOUSE DR",
"city": "ATOKA",
"state": "OK",
"postal_code": "745253434",
"telephone_number": "580-889-6611",
"fax_number": "580-324-4181"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1680 S GREATHOUSE DRIVE",
"city": "ATOKA",
"state": "OK",
"postal_code": "745257452",
"telephone_number": "808-896-6115",
"fax_number": "580-324-4181"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FISHER",
"first_name": "JADA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2022-08-15",
"last_updated": "2023-01-17",
"certification_date": "2023-01-17",
"deactivation_date": "2022-10-07",
"reactivation_date": "2023-01-17",
"status": "A"
},
"taxonomies": [
{
"code": "3747P1801X",
"taxonomy_group": "",
"desc": "Technician, Personal Care Attendant",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "100683770A",
"state": "OK"
}
],
"endpoints": [
{
"endpointType": "CONNECT",
"endpointTypeDescription": "CONNECT URL",
"endpoint": "Atoka",
"affiliation": "N",
"endpointDescription": "1680 S Greathouse Dr",
"use": "OTHER",
"useDescription": "Other",
"useOtherDescription": "Atoka",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "Atoka",
"address_1": "1680 S Greathouse Drive",
"city": "Atoka",
"state": "OK",
"country_code": "US",
"postal_code": "745257452",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Atoka, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 17, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.