Individual provider Active NPI

Justin Fiscus, RN

  • Home Health Agency
  • Summerfield, FL
National Provider Identifier
1770912628
Registry record updated May 20, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
Practice address
15580 S US Highway 441
8
Summerfield, FL 34491-4426
Phone
(844) 428-9987
Fax
(978) 232-1981
NPI assigned
Nov 1, 2013
Last updated
May 20, 2015By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 20, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X Primary

Addresses

Primary practice location

15580 S US Highway 441
8
Summerfield, FL 34491-4426

Mailing address

784 Yemassee Loop
The Villages, FL 32162-1461
Phone (513) 535-3284

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
Credentials
Registered Nurse

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.

NPI Registry JSON

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

{
    "created_epoch": "1383264000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1432080000000",
    "number": "1770912628",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "784 YEMASSEE LOOP",
            "city": "THE VILLAGES",
            "state": "FL",
            "postal_code": "321621461",
            "telephone_number": "513-535-3284"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15580 S US HIGHWAY 441",
            "address_2": "8",
            "city": "SUMMERFIELD",
            "state": "FL",
            "postal_code": "344914426",
            "telephone_number": "844-428-9987",
            "fax_number": "978-232-1981"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FISCUS",
        "first_name": "JUSTIN",
        "name_prefix": "Mr.",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-11-01",
        "last_updated": "2015-05-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Summerfield, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.