Active NPI
Nicole Fisher, LICSW
- Clinical Social Worker
- Shoreview, MN
National Provider Identifier
1902213705
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 23465
- Practice address
- 5985 Rice Creek Pkwy
Shoreview, MN 55126-5038 - Phone
- (651) 348-7240
- NPI assigned
- Jul 14, 2014
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | |||
| Clinical Social Worker | 1041C0700X | 23465 | MN | Primary |
Addresses
Primary practice location
5985 Rice Creek Pkwy
Shoreview, MN 55126-5038
Mailing address
5985 Rice Creek Pkwy
Shoreview, MN 55126-5038
Phone (651) 348-7240
Other names 1
- Nicole Gauer Patnode Fisher
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MN
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Social Worker
- Education
- Other, 2014
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
3450 Oleary LN
Eagan, MN 55123-2340
Phone (651) 454-0114
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
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.
-
- Clinical Psychologist
- Eagan, MN
- NPI 1144311184
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1405296000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1703116800000",
"number": "1902213705",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5985 RICE CREEK PKWY",
"city": "SHOREVIEW",
"state": "MN",
"postal_code": "551265038",
"telephone_number": "651-348-7240"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5985 RICE CREEK PKWY",
"city": "SHOREVIEW",
"state": "MN",
"postal_code": "551265038",
"telephone_number": "651-348-7240"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FISHER",
"first_name": "NICOLE",
"credential": "LICSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-07-14",
"last_updated": "2023-12-21",
"certification_date": "2023-12-21",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": null,
"license": null,
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "MN",
"license": "23465",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "NICOLE",
"last_name": "FISHER",
"middle_name": "GAUER PATNODE",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Shoreview, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 21, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.