Individual provider Active NPI

Cory M Fisher, DO

  • Family Medicine Physician
  • Rocky River, OH
National Provider Identifier
1730304304
Registry record updated Jun 26, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
34.008679 Issued in OH
Practice address
19324 Detroit Rd
Rocky River, OH 44116-1802
Phone
(440) 356-3640
Fax
(440) 356-3729
NPI assigned
Apr 17, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 26, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 34.008679 OH Primary

Addresses

Primary practice location

19324 Detroit Rd
Rocky River, OH 44116-1802

Mailing address

19324 Detroit Rd
Rocky River, OH 44116-1802
Phone (440) 356-3640

Other identifiers 5

IdentifierTypeStateIssuer
000000526275OtherANTHEM BC/BS
00000526262OtherANTHEM BC/BS
2749066MedicaidOH
P00441657OtherOHRRCARE
P00705928OtherOHRAILROAD CARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20071219000430 OH Practitioner - Family Practice 1052401692 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Ohio University, College of Osteopathic Medicine, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Cleveland ClinicGroup PAC ID 1850203555, 6,954 clinicians

Practice addresses (Care Compare)

14601 Detroit Ave
Lakewood, OH 44107-4205

19324 Detroit Rd
Rocky River, OH 44116-1802
Phone (440) 356-3640

8950 Euclid Ave
Cleveland, OH 44195-0001
Phone (216) 444-8950

9500 Euclid Ave
Cleveland, OH 44195-0001

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
34.008679OHMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The Cleveland Clinic Foundation CurrentSince Sep 8, 2015 Accepting new patients
Euclid Hospital Cleveland Clinic Health System Current Accepting new patients
Lakewood Hospital Association Past Accepting new patients
Lakewood Hospital Association Family Medicine Past Accepting new patients

Locations

36901 American Way
Avon, OH 44011
Phone (440) 930-6200

9500 Euclid Ave
Cleveland, OH 44195
Phone (216) 442-1270

14601 Detroit Ave
Lakewood, OH 44107
Phone (216) 237-5500

19324 Detroit Rd
Rocky River, OH 44116
Phone (440) 356-3496

850 Columbia Rd
Ste 105
Westlake, OH 44145
Phone (440) 250-5737

Interoperability endpoints

  • Direct secure messaging: cfisherdo28752@direct.ccf.org

Organizations & group practices 4

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.

Hospital & facility affiliations 4

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": "1176768000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1245974400000",
    "number": "1730304304",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19324 DETROIT RD",
            "city": "ROCKY RIVER",
            "state": "OH",
            "postal_code": "441161802",
            "telephone_number": "440-356-3640",
            "fax_number": "440-356-3729"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19324 DETROIT RD",
            "city": "ROCKY RIVER",
            "state": "OH",
            "postal_code": "441161802",
            "telephone_number": "440-356-3640",
            "fax_number": "440-356-3729"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FISHER",
        "first_name": "CORY",
        "middle_name": "M",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-17",
        "last_updated": "2009-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OH",
            "license": "34.008679",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BC/BS",
            "identifier": "000000526275",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BC/BS",
            "identifier": "00000526262",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2749066",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RRCARE",
            "identifier": "P00441657",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD CARE",
            "identifier": "P00705928",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Rocky River, OH

Sources for this page

Verify at the official NPI Registry.