Individual provider Active NPI

Gabrielle A. Fish, D.O.

  • Adult Medicine Physician
  • Cherry Hill, NJ
National Provider Identifier
1891862090
Registry record updated May 20, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Medicine PhysicianTaxonomy code 207QA0505X
License
OS008700L Issued in PA
Practice address
432 Columbia Blvd
Cherry Hill, NJ 08002-1625
Phone
(856) 427-4001
Fax
(856) 427-4003
NPI assigned
Nov 30, 2006
Sex
Female
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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Medicine Physician 207QA0505X OS008700L PA Primary
Adult Medicine Physician 207QA0505X 25MB06304700 NJ

Addresses

Primary practice location

432 Columbia Blvd
Cherry Hill, NJ 08002-1625

Mailing address

432 Columbia Blvd
Cherry Hill, NJ 08002-1625
Phone (856) 427-4001

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040804001159 PA Practitioner - Family Practice 1153392923

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
25MB06304700NJMDAdult Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The Visiting Nurse Association of Greater Philadelphia Past Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1164844800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1432080000000",
    "number": "1891862090",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "432 COLUMBIA BLVD",
            "city": "CHERRY HILL",
            "state": "NJ",
            "postal_code": "080021625",
            "telephone_number": "856-427-4001",
            "fax_number": "856-427-4003"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "432 COLUMBIA BLVD",
            "city": "CHERRY HILL",
            "state": "NJ",
            "postal_code": "080021625",
            "telephone_number": "856-427-4001",
            "fax_number": "856-427-4003"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FISH",
        "first_name": "GABRIELLE",
        "middle_name": "A.",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-11-30",
        "last_updated": "2015-05-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QA0505X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Adult Medicine",
            "state": "PA",
            "license": "OS008700L",
            "primary": true
        },
        {
            "code": "207QA0505X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Adult Medicine",
            "state": "NJ",
            "license": "25MB06304700",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cherry Hill, NJ

Sources for this page

Verify at the official NPI Registry.