Charles Brandon Fisher, D.O.

Primary specialty

Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X

License

3621 Issued in TN

Practice address

501 20TH St Ste 503
Knoxville, TN 37916-1832

Phone

(865) 331-4321

Fax

(865) 331-4320

NPI assigned

Mar 4, 2015

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in TN

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

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.

• Covenant Medical Group, Inc.

  • Family Medicine Physician
  • Knoxville, TN
  • NPI 1457302010

  Physical Medicine & Rehabilitation

  Medicare reassignment NPD
• Covenant Medical Group, Inc

  • Durable Medical Equipment & Medical Supplies
  • Knoxville, TN
  • NPI 1871269415
  NPD

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

{
    "created_epoch": "1425427200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1549843200000",
    "number": "1972995603",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "501 20TH ST STE 503",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379161832",
            "telephone_number": "865-331-4321",
            "fax_number": "865-331-4320"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 20TH ST STE 503",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379161832",
            "telephone_number": "865-331-4321",
            "fax_number": "865-331-4320"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FISHER",
        "first_name": "CHARLES",
        "middle_name": "BRANDON",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-03-04",
        "last_updated": "2019-02-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "TN",
            "license": "3621",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "Q046549",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Madison Paige Fischer
• Jennifer Lee Anne Fish
• Lea Ann Fish
• Fisher Therapeutics
• Alicia Nash Fisher, MS-SLP
• Charles Daniel Fisher, DENTIST
• Desaray Fisher, COTA
• Jessica Fisher, MA
• Keri Fisher, PA-C
• Leesa Fisher, RN

• Physical Medicine & Rehabilitation Physician in Knoxville, TN
• Providers in Knoxville, TN by specialty
• Physical Medicine & Rehabilitation Physician in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2019; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.