NPIMap

Organization Active NPI

Jack E Fisher DPM Inc

Doing business as Gavilan Foot Care

  • Foot & Ankle Surgery Podiatrist
  • Gilroy, CA
National Provider Identifier
1780794644
Registry record updated Aug 27, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
E1702 Issued in CA
Legal business name
JACK E FISHER DPM INC
Doing business as
Gavilan Foot Care
Practice address
80 5TH St
Gilroy, CA 95020-5702
Phone
(408) 842-0281
Fax
(408) 848-4341
NPI assigned
Aug 30, 2006
Last updated
Aug 27, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 27, 2014

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

Authorized official

Name
Jack Fisher, DPMNPI 1629072392
Title
Owner/Physician
Phone
(408) 842-0281

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Foot & Ankle Surgery Podiatrist 213ES0103X E1702 CA Primary

Addresses

Primary practice location

80 5TH St
Gilroy, CA 95020-5702

Mailing address

80 5TH St
Gilroy, CA 95020-5702
Phone (408) 842-0281

Other identifiers 3

IdentifierTypeStateIssuer
1780794644OtherCAGROUP NPI
E1702OtherCALICENSE
1629072392OtherCAINDIVIDUAL NPI

Other names 1

  • Gavilan Foot Care Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1156896000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1409097600000",
    "number": "1780794644",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "80 5TH ST",
            "city": "GILROY",
            "state": "CA",
            "postal_code": "950205702",
            "telephone_number": "408-842-0281",
            "fax_number": "408-848-4341"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "80 5TH ST",
            "city": "GILROY",
            "state": "CA",
            "postal_code": "950205702",
            "telephone_number": "408-842-0281",
            "fax_number": "408-848-4341"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JACK E FISHER DPM INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-30",
        "last_updated": "2014-08-27",
        "status": "A",
        "authorized_official_last_name": "FISHER",
        "authorized_official_first_name": "JACK",
        "authorized_official_title_or_position": "OWNER/PHYSICIAN",
        "authorized_official_telephone_number": "408-842-0281",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "CA",
            "license": "E1702",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP NPI",
            "identifier": "1780794644",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "E1702",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDIVIDUAL NPI",
            "identifier": "1629072392",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Gavilan Foot Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Gilroy, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2014; 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.