Individual provider Active NPI

Eileen M Fish, MD

  • Nephrology Physician
  • Lone Tree, CO
National Provider Identifier
1982747374
Registry record updated Apr 22, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
31255 Issued in CO
Practice address
9777 S Yosemite St Ste 110
Lone Tree, CO 80124-3115
Phone
(720) 696-0852
Fax
(720) 696-0892
NPI assigned
Feb 15, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 22, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician 207RN0300X 31255 CO Primary

Addresses

Primary practice location

9777 S Yosemite St Ste 110
Lone Tree, CO 80124-3115

Mailing address

9777 S Yosemite St Ste 110
Lone Tree, CO 80124-3115
Phone (720) 696-0852

Other identifiers 1

IdentifierTypeStateIssuer
01312552MedicaidCO

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address eileen.fish.1@19427.direct.athenahealth.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
31255COMDNephrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Western Nephrology & Metabolic Bone Disease, P.C. Nephrology PastSince Sep 20, 2020 Accepting new patients
Altitude Kidney Health PLLC Nephrology PastSince Apr 1, 2019 Accepting new patients

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/ACHACA

Organizations & group practices 2

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": "1171497600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1650585600000",
    "number": "1982747374",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9777 S YOSEMITE ST STE 110",
            "city": "LONE TREE",
            "state": "CO",
            "postal_code": "801243115",
            "telephone_number": "720-696-0852",
            "fax_number": "720-696-0892"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9777 S YOSEMITE ST STE 110",
            "city": "LONE TREE",
            "state": "CO",
            "postal_code": "801243115",
            "telephone_number": "720-696-0852",
            "fax_number": "720-696-0892"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FISH",
        "first_name": "EILEEN",
        "middle_name": "M",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-02-15",
        "last_updated": "2022-04-22",
        "certification_date": "2022-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "CO",
            "license": "31255",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01312552",
            "state": "CO"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "eileen.fish.1@19427.direct.athenahealth.com",
            "affiliation": "N",
            "address_1": "9777 S Yosemite St Ste 110",
            "city": "Lone Tree",
            "state": "CO",
            "country_code": "US",
            "postal_code": "801243115",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Lone Tree, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.