Lance Steven Fisher, PA

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

2412 Issued in AZ

Practice address

5702 W Campbell Ave
Phoenix, AZ 85031

Phone

(623) 848-5000

NPI assigned

Dec 6, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 5

Medicare fee-for-service enrollment

Enrolled in MN

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 1

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

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.

• Brainerd Medical Center Inc

  • General Practice Physician
  • Brainerd, MN
  • NPI 1295801777
  Medicare reassignment NPD
• Essentia Health Virginia, LLC

  • General Acute Care Hospital
  • Virginia, MN
  • NPI 1083617120
  Medicare reassignment NPD
• St Marys Medical Center

  • General Acute Care Hospital
  • Duluth, MN
  • NPI 1457393035
  Medicare reassignment NPD
• St. Joseph'S Medical Center

  • General Acute Care Hospital
  • Brainerd, MN
  • NPI 1568415974
  Medicare reassignment
• Brainerd Medical Center Inc

  • Clinic Pharmacy
  • Brainerd, MN
  • NPI 1053342329
  NPD
• Brainerd Medical Center Inc.

  • Clinic Pharmacy
  • Staples, MN
  • NPI 1972350486
  NPD
• Essentia Health Virginia, LLC

  • Rural Health Clinic/Center
  • International Falls, MN
  • NPI 1881144970
  NPD
• St Joseph'S Medical Center

  • Multi-Specialty Clinic/Center
  • Staples, MN
  • NPI 1538916101
  NPD
• St. Joseph'S Medical Center

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Brainerd, MN
  • NPI 1740393032
  NPD
• St. Mary'S Medical Center

  • Clinic/Center
  • Duluth, MN
  • NPI 1821835851
  NPD
• Emergency Physician Professional Association, LTD.

  • Emergency Medicine Physician
  • Glendale, AZ
  • NPI 1396769972
  NPD (past)
• Emergency Physicians Professional Association LTD

  • Emergency Medicine Physician
  • Phoenix, AZ
  • NPI 1114931490
  NPD (past)

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

{
    "created_epoch": "1133827200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1454025600000",
    "number": "1720062417",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13512 W READE AVE",
            "city": "LITCHFIELD PARK",
            "state": "AZ",
            "postal_code": "853404019",
            "telephone_number": "623-535-4372"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5702 W CAMPBELL AVE",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "85031",
            "telephone_number": "623-848-5000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FISHER",
        "first_name": "LANCE",
        "middle_name": "STEVEN",
        "name_prefix": "Mr.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-06",
        "last_updated": "2016-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "AZ",
            "license": "2412",
            "primary": true
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MN",
            "license": "11450",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "538192",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HUMANA GROUP",
            "identifier": "860373636",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHNET GROUP",
            "identifier": "AW1436",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EVERCARE GROUP",
            "identifier": "3981220",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP HEALTH GROUP",
            "identifier": "453051001",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• James W. Fisher, M.D.
• Joseph Fisher, M.D.
• Katie Elizabeth Fisher, PA-C
• Kelsey Fisher, PA
• Kenneth Fisher, MD
• Landa Fisher, DPT
• Lauren Juliet Fisher, DO
• Lynette Ann Fisher
• Melissa Fisher, RN
• Molly Fisher, LISAC

• Emergency Medicine Physician in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• Emergency Medicine Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.