Individual provider Active NPI

Christy Fisher, LMSW

  • Social Worker
  • Council Bluffs, IA
National Provider Identifier
1891085205
Registry record updated Aug 27, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
06788 Issued in IA
Practice address
500 Willow Ave
Ste 215
Council Bluffs, IA 51503-0827
Phone
(402) 541-5674
Fax
(712) 256-1312
NPI assigned
Apr 19, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 27, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 06788 IA Primary

Addresses

Primary practice location

500 Willow Ave
Ste 215
Council Bluffs, IA 51503-0827

Mailing address

500 Willow Ave
Ste 215
Council Bluffs, IA 51503-0827
Phone (402) 541-5674

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150811005534 IA Practitioner - Clinical Social Worker 2769619634 Practice locations: Council Bluffs, IA

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

1023 Pine St
Council Bluffs, IA 51501-5823
Phone (402) 541-5674

500 Willow Ave
Suite 215
Council Bluffs, IA 51503-0827
Phone (402) 541-5674

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1531NEMDOptometrist

NPI Registry JSON

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

{
    "created_epoch": "1303171200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1566864000000",
    "number": "1891085205",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 WILLOW AVE",
            "address_2": "STE 215",
            "city": "COUNCIL BLUFFS",
            "state": "IA",
            "postal_code": "515030827",
            "telephone_number": "402-541-5674",
            "fax_number": "712-256-1312"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 WILLOW AVE",
            "address_2": "STE 215",
            "city": "COUNCIL BLUFFS",
            "state": "IA",
            "postal_code": "515030827",
            "telephone_number": "402-541-5674",
            "fax_number": "712-256-1312"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FISHER",
        "first_name": "CHRISTY",
        "credential": "LMSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-04-19",
        "last_updated": "2019-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "IA",
            "license": "06788",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Council Bluffs, IA

Sources for this page

Verify at the official NPI Registry.