MR. MARK A FISHER (NPI# 1144215153) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1144215153 |
| Entity Type | Individual |
| Full Name | MR. MARK A FISHER |
| Credential | PA-C |
| Practice Address |
1721 Magnavox Way Fort Wayne IN 46804-1537 |
| Mailing Address |
Po Box 670 Huntertown IN 46748-0670 |
| Practice Telephone | 2607483650 |
| Practice Fax Number | 3607483651 |
| Mailing Telephone | 2607483650 |
| Mailing Fax Number | 2607483651 |
| Enumeration Date | 2005-09-15 |
| Last Update Date | 2019-02-04 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AM0700X |
Physician Assistant Specialization: Medical |
10000311A | IN | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IN | 300006102 | 05 | |
| IN | BCBS | 931711 | 01 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 2124 N Biomet Dr, Warsaw, IN 465827858 | 2607483650 | 2607483651 |
| 6811 Lima Rd, Fort Wayne, IN 468181145 | 2607483650 | 2607483651 |
| 1314 E 7th St Ste 201, Auburn, IN 467062533 | 2607483650 | 2607483651 |
| 2512 E Dupont Rd Ste 200, Fort Wayne, IN 46825 | 2607483650 | 2607483651 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518312941 | Mark Fisher | Registered Nurse | 13 Main Ave, Wilmington, DE 19804 | 2016-05-04 |
| 1144567538 | Mark R Fisher | Hearing Instrument Specialist | 1111 Park Ave Sw, Canton, OH 44706-1545 | 2013-01-07 |
| 1053614073 | Mark Alan Fisher | Massage Therapist | 916 Ne 17th Ct, Fort Lauderdale, FL 33305-3127 | 2010-12-13 |
| 1477676708 | Mark Steven Fisher | Dentist | 26 Dillmont Dr, Columbus, OH 43235-6424 | 2007-04-10 |
| 1568526143 | Mark Fisher | Optometrist | 12701 Wayzata Blvd # 249, Minnetonka, MN 55305-1943 | 2006-12-20 |
| 1821167123 | Mark E Fisher | Dentist | 2000 Dean Ave Se, Rome, GA 30161-6602 | 2006-11-08 |
| 1659457950 | Mark Louis Fisher | Psychologist | 537 Ritchie Hwy Ste 1c, Severna Park, MD 21146-2930 | 2006-10-29 |
| 1114008653 | Mark Renard Fisher | Physical Therapist | 1321 College St Ste D, Woodland, CA 95695-4706 | 2006-10-18 |
| 1609961937 | Mark Fisher | Internal Medicine | 713 Station Ave, Haddon Heights, NJ 08035-1648 | 2006-10-03 |
| 1003852716 | Mark Allen Fisher | Obstetrics & Gynecology | 634 W Pinon St, Farmington, NM 87401-5915 | 2006-06-21 |
| Street Address |
1721 MAGNAVOX WAY |
| City | FORT WAYNE |
| State | IN |
| Zip Code | 46804-1537 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750991147 | Coffman Anesthesiology LLC | Anesthesiology | 1721 Magnavox Way, Fort Wayne, IN 46804-1537 | 2020-07-31 |
| 1821606500 | Makayla Lawson | Nurse Practitioner | 1721 Magnavox Way, Fort Wayne, IN 46804-1537 | 2020-07-17 |
| 1780218115 | Surgery Center of Fort Wayne | Clinic/Center | 1721 Magnavox Way, Fort Wayne, IN 46804-1537 | 2020-02-25 |
| 1689216442 | Karmen Wilson | Registered Nurse | 1721 Magnavox Way, Fort Wayne, IN 46804-1537 | 2019-10-14 |
| 1295207488 | Lacey Michelle Harvey | Physician Assistant | 1721 Magnavox Way, Fort Wayne, IN 46804-1537 | 2018-12-28 |
| 1982061701 | Jonathan Notelle | Registered Nurse | 1721 Magnavox Way, Fort Wayne, IN 46804-1537 | 2016-01-25 |
| 1548696206 | Thomas A. Straub | Physician Assistant | 1721 Magnavox Way, Fort Wayne, IN 46804-1537 | 2013-09-25 |
| 1679909931 | Jason T. Gaisford | Physician Assistant | 1721 Magnavox Way, Fort Wayne, IN 46804-1537 | 2013-09-18 |
| 1861687923 | Daniel Christopher Roth | Physical Medicine & Rehabilitation | 1721 Magnavox Way, Fort Wayne, IN 46804-1537 | 2007-09-12 |
| 1982654828 | Robert Franklin Jackson II | Orthopaedic Surgery | 1721 Magnavox Way, Fort Wayne, IN 46804-1537 | 2006-05-11 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396350344 | Derek Mumaw | Physical Therapist | 8420 Illinois Rd, Fort Wayne, IN 46804 | 2020-09-15 |
| 1942840228 | Erin M Mason | Behavior Technician | 5601 Coventry Ln, Fort Wayne, IN 46804 | 2020-01-14 |
| 1346880879 | Emily A Abdalla | Behavior Technician | 5601 Coventry Ln., Fort Wayne, IN 46804 | 2020-01-13 |
| 1083265433 | Fort Wayne Endodontics | Dentist | 9407 Illinois Rd, Fort Wayne, IN 46804 | 2019-09-26 |
| 1689140949 | Harrison Dental Group II, LLC | Dentist | 1333 Getz Rd, Fort Wayne, IN 46804 | 2018-10-15 |
| 1346731908 | Erin Nicole Zimmerman | Nurse Practitioner | 10170 Illinois Rd # 14, Fort Wayne, IN 46804 | 2018-05-19 |
| 1417446022 | Mary Harrington | Physical Therapist | 3320 Copper Hill Run, Fort Wayne, IN 46804 | 2018-05-09 |
| 1942701214 | Joshawa Todd Torres | Marriage & Family Therapist | 5651 Coventry Ln # 116, Fort Wayne, IN 46804 | 2018-02-22 |
| 1194235408 | Mitchell Kory Meyer | Specialist/Technologist | 9125 Yellow Tree Ct, Fort Wayne, IN 46804 | 2017-10-02 |
| 1902324916 | Emily Rene Sagstetter | Specialist/Technologist | 6034 Liberty Glade Ct, Fort Wayne, IN 46804 | 2017-08-30 |
| Find all providers in zip 46804 | ||||
| Taxonomy Code | 363AM0700X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Medical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275142986 | Bradley Ophoff | Physician Assistant | 1819 Carew St, Fort Wayne, IN 46805-4705 | 2020-07-28 |
| 1073963351 | Jenifer Kay Fortney | Physician Assistant | 5650 Coventry Ln, Fort Wayne, IN 46804-7140 | 2016-06-16 |
| 1972900199 | Rachel Mcpherson | Physician Assistant | 7333 W Jefferson Blvd, Fort Wayne, IN 46804-6280 | 2014-12-03 |
| 1730581067 | Keith William Lowe | Physician Assistant | 11109 Parkview Plaza Dr, Fort Wayne, IN 46845-1701 | 2014-09-18 |
| 1528321759 | Sarita Ruetz | Physician Assistant | 11109 Parkview Plaza Dr, Fort Wayne, IN 46845-1701 | 2012-06-21 |
| 1760765945 | Jennifer Raye Myers | Physician Assistant | 7333 W Jefferson Blvd, Fort Wayne, IN 46804-6280 | 2011-09-23 |
| 1841421583 | Nathaniel D Roach | Physician Assistant | 5050 N Clinton St, Fort Wayne, IN 46825-5886 | 2009-07-29 |
| 1265678486 | Cheryl Lynn Kiel | Physician Assistant | 11109 Parkview Plaza Dr, Fort Wayne, IN 46845-1701 | 2008-12-17 |
| 1407010564 | Emily E Lierman | Physician Assistant | 2200 Randallia Dr., Fort Wayne, IN 46805-4638 | 2008-07-17 |
| 1750545414 | Briana Nicole Aspy | Physician Assistant | 11141 Parkview Plaza Dr, Suite 210, Fort Wayne, IN 46845-1713 | 2008-07-11 |
| Find all providers in FORT WAYNE | ||||
| City | FORT WAYNE |
| Zip Code | 46804 |
Please comment or provide details below to improve the information on MR. MARK A FISHER.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.