Individual provider Active NPI

Kyle Alexander Fisher, RN

  • Emergency Registered Nurse
  • Jeffersonville, IN
National Provider Identifier
1740064690
Registry record updated Aug 22, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Registered NurseTaxonomy code 163WE0003X
License
28214415A Issued in IN
Practice address
1220 Missouri Ave
Jeffersonville, IN 47130-3743
Phone
(812) 283-2521
NPI assigned
Aug 22, 2023
Last updated
Aug 22, 2023By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 22, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Registered Nurse 163WE0003X 28214415A IN Primary

Addresses

Primary practice location

1220 Missouri Ave
Jeffersonville, IN 47130-3743

Mailing address

1220 Missouri Ave
Jeffersonville, IN 47130-3743
Phone (812) 283-2521

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
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

Enrollment IDStateProvider typePAC IDDetails
I20240905000113 IN Practitioner - Nurse Practitioner 3971043969 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Emergency Medicine Physicians Associates PCGroup PAC ID 6709122724, 19 clinicians

Practice addresses (Care Compare)

1220 Missouri Ave
Jeffersonville, IN 47130-3725
Phone (812) 283-2581

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Emergency Medicine Physicians Associates PC CurrentSince Jun 2, 2024 Accepting new patients

Locations

1220 Missouri Ave
Jeffersonvlle, IN 47130
Phone (812) 282-2072

Organizations & group practices 1

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": "1692662400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692662400000",
    "number": "1740064690",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1220 MISSOURI AVE",
            "city": "JEFFERSONVILLE",
            "state": "IN",
            "postal_code": "471303743",
            "telephone_number": "812-283-2521"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1220 MISSOURI AVE",
            "city": "JEFFERSONVILLE",
            "state": "IN",
            "postal_code": "471303743",
            "telephone_number": "812-283-2521"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FISHER",
        "first_name": "KYLE",
        "middle_name": "ALEXANDER",
        "name_prefix": "Mr.",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-08-22",
        "last_updated": "2023-08-22",
        "certification_date": "2023-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WE0003X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Emergency",
            "state": "IN",
            "license": "28214415A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jeffersonville, IN

Sources for this page

Verify at the official NPI Registry.