DR. MARK FISHERKELLER (NPI# 1629026380) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1629026380 |
| Entity Type | Individual |
| Full Name | DR. MARK FISHERKELLER |
| Credential | M.D. |
| Practice Address |
90 Quarry St Willimantic CT 06226-1225 |
| Practice Telephone | 8604562898 |
| Practice Fax Number | 8604563078 |
| Mailing Telephone | 8604562898 |
| Mailing Fax Number | 8604563078 |
| Enumeration Date | 2006-05-05 |
| Last Update Date | 2012-05-04 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RC0000X |
Internal Medicine Specialization: Cardiovascular Disease |
021796 | CT | Allopathic & Osteopathic Physicians |
| N | 207UN0901X |
Nuclear Medicine Specialization: Nuclear Cardiology |
021796 | CT | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CT | 001217967 | 05 |
| Street Address |
90 QUARRY ST |
| City | WILLIMANTIC |
| State | CT |
| Zip Code | 06226-1225 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568468213 | Francis Siracusa | Surgery | 90 Quarry St, Willimantic, CT 06226-1225 | 2005-06-27 |
| 1700946068 | Surgical Associates of Windham PC | Specialist | 90 Quarry St, Willimantic, CT 06226-1225 | 2006-12-09 |
| 1366538381 | Quarry St. Internal Medicine, LLC | Internal Medicine | 90 Quarry St, Willimantic, CT 06226-1225 | 2006-10-05 |
| 1467403808 | Windham Cardiology, P.C. | Internal Medicine | 90 Quarry St, Willimantic, CT 06226-1225 | 2006-05-12 |
| 1316918089 | Victorio Go Te | Internal Medicine | 90 Quarry St, Willimantic, CT 06226-1225 | 2006-01-30 |
| 1164421145 | Charles A. Shooks | Internal Medicine | 90 Quarry St, Willimantic, CT 06226-1225 | 2005-07-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669962163 | Nutmeg Neuropsychology LLC | Psychologist | 322 Main St Ste 2e-1o, Willimantic, CT 06226 | 2018-05-10 |
| 1104344365 | Taylor Girard | Social Worker | 54-56 Boston Post Road, Willimantic, CT 06226 | 2017-09-07 |
| 1194268490 | Donald Diange | Pharmacist | 1391 Main Street, Willimantic, CT 06226 | 2016-11-18 |
| 1386988954 | Gale K Lockland | Psychologist | 112 Mansfield Avenue, Windham Community Memorial Hospital, Willimantic, CT 06226 | 2012-11-20 |
| 1831343060 | Carlita R Baldwin | Counselor | 366 Ash Street, Unit 4, Willimantic, CT 06226 | 2008-11-14 |
| 1023211190 | Joel Lee Reinholtz | Physical Therapy Assistant | 595 Valley Street, Windham, CT 06226 | 2007-06-07 |
| 1265654719 | Mcsweeney Regional Senior Center | Clinic/Center | 47 Crescent St, Willimantic, CT 06226 | 2007-05-03 |
| 1912012964 | John Wescott Stevens | Dentist | 1581 W Main St, Willmantic, CT 06226 | 2006-08-20 |
| 1801802756 | Kathryn Nelson | Family Medicine | 355 High Street, Willimantic, CT 06226 | 2006-07-31 |
| 1710914379 | The Foot Group, LLC | Podiatrist | 162 A Mansfield Ave, Willimantic, CT 06226 | 2006-06-27 |
| Find all providers in zip 06226 | ||||
| Taxonomy Code | 207RC0000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Cardiovascular Disease |
| An internist who specializes in diseases of the heart and blood vessels and manages complex cardiac conditions such as heart attacks and life-threatening, abnormal heartbeat rhythms. |
| Notes: Source: American Osteopathic Board of Internal Medicine, 2008 [7/1/2008: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, http://www.abim.org/. American Osteopathic Board of Internal Medicine, https://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225002496 | Mansfield Cardiovascular Care LLC | Internal Medicine | 6 Storrs Rd, Suite 6, Willimantic, CT 06226 | 2006-02-15 |
| 1952629685 | Elenita Ilieva Kanin | Internal Medicine | 5 Founders St, Willimantic, CT 06226-2048 | 2010-05-05 |
| 1619919313 | Jeffrey Glen Kegel | Internal Medicine | 5 Founders St, Willimantic, CT 06226 | 2006-06-10 |
| 1467403808 | Windham Cardiology, P.C. | Internal Medicine | 90 Quarry St, Willimantic, CT 06226-1225 | 2006-05-12 |
| 1447201793 | Eastern Connecticut Heart Associates | Internal Medicine | 112 Mansfield Ave, Willimantic, CT 06226-2041 | 2006-05-12 |
| 1790753184 | Anthea Fiona Woodley | Internal Medicine | 6 Storrs Rd, Ste 6, Willimantic, CT 06226 | 2006-03-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922527050 | Lindacare Inc. | Internal Medicine | 20 Church St Ste 1780, Hartford, CT 06103-1246 | 2017-09-09 |
| 1740678135 | Post-acute Cardiology Care LLC | Internal Medicine | 30 Old Kings Hwy S Ste 160, Darien, CT 06820-4519 | 2015-01-07 |
| 1144630328 | Allison Padegimas | Internal Medicine | 1062 Barnes Rd Ste 300, Wallingford, CT 06492-2576 | 2014-04-28 |
| 1871913244 | Jason Michael Goodman | Internal Medicine | 111 Osborne St Fl 3, Danbury, CT 06810-6000 | 2014-04-23 |
| 1669899829 | Kyla D'angelo | Internal Medicine | 1260 Silas Deane Hwy Ste 109, Wethersfield, CT 06109-4363 | 2014-03-26 |
| 1598100869 | Seabright Cardiovascular Center, LLC | Internal Medicine | 353 Bridgeport Ave, Milford, CT 06460 | 2013-05-01 |
| 1427311711 | Qurat-ul-ain Jelani | Internal Medicine | Section of Cardiovascular Medicine., Yale New Haven Hospital. 20. York Street, New Haven, CT 06510 | 2012-06-21 |
| 1760744643 | Michael M Cebrik | Internal Medicine | 4 Oxford Court, Avon, CT 06001-4556 | 2012-06-15 |
| 1467710657 | Andrew Beck | Internal Medicine | 112 Quarry Rd Ste 400, Trumbull, CT 06611-4877 | 2012-04-25 |
| 1316203482 | James J Purcell | Internal Medicine | 31 Woodland Street, Apt. 4p, Hartford, CT 06105 | 2012-04-03 |
| Find all providers with the same taxonomy | ||||
| City | WILLIMANTIC |
| Zip Code | 06226 |
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| 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.