Zachary Douglas Fisher, PA-C
Individual provider Active NPI Physician Assistant · Enterprise, UT
NPI 1851063176 · NPPES record last updated Oct 5, 2021
Key facts
- NPI
- 1851063176
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physician Assistant 363A00000X
- License
- 12451849-1206 (UT)
- Practice address
- 257 S 625 E
Enterprise, UT 84725 - Phone
- (435) 669-6168
- NPI assigned
- Oct 5, 2021
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 4
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in UT
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20220117000173 | UT | Practitioner - Physician Assistant | 7416349840 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Physician Assistant
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Ihc Health Services, Inc. | Current |
Accepting new patients | |
| Ihc Health Services Inc | Current |
Accepting new patients |
Locations
700 S Highway 99
Ste 3
Fillmore, UT 84631
Phone (435) 743-5555
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 12451849-1206 | UT | Yes |
Addresses
Primary practice location
257 S 625 E
Enterprise, UT 84725
Mailing address
PO Box 1121
Enterprise, UT 84725-1121
Phone (435) 669-6168
Other providers in Enterprise, UT
- City of Enterprise Ambulance
- Celestia Luella Clark I
- Benjamin D Cope
- Enterprise Valley Med Ctr Inc
- Enterprise Valley Medical Clinic, Inc.
- Jessica Gardner
- Erin Grover
- Lexi Ann Hartley
- Kody Keith Holt
- McKay Jones
All providers in Enterprise, UT · Physician Assistant in Utah
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 5, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.