JONATHAN DONALD FISHER (NPI# 1891969606) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1891969606 |
| Entity Type | Individual |
| Full Name | JONATHAN DONALD FISHER |
| Credential | DPM |
| Practice Address |
30544 Highway 200 Suite 102 Ponderay ID 83852-5005 |
| Practice Telephone | 2082659817 |
| Practice Fax Number | 2082654533 |
| Mailing Telephone | 2082659817 |
| Mailing Fax Number | 2082654533 |
| Enumeration Date | 2008-04-14 |
| Last Update Date | 2013-04-05 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 213ES0103X |
Podiatrist Specialization: Foot & Ankle Surgery |
P-198 | ID | Podiatric Medicine & Surgery Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| ID | REGENCE BLUE SHIELD | 000010167109 | 01 |
| ID | MEDICARE | 1100300 | 01 |
| ID | 808011000 | 05 | |
| ID | RAILROAD MEDICARE | P00638389 | 01 |
| ID | BLUE CROSS | P2448 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437640299 | Jonathan Lloyd Fisher | Student in an Organized Health Care Education/Training Program | 7703 Floyd Curl Dr # 7843, San Antonio, TX 78229-3901 | 2018-05-28 |
| 1255523700 | Jonathan Bernard Fisher | Dentist | 6302 W Elderberry Dr Apt A, Usaf Academy, CO 80840-1306 | 2007-08-17 |
| 1649476359 | Jonathan George Robert Samuel Fisher | Otolaryngology | 85 Southwood Dr, Orinda, CA 94563-3026 | 2007-06-21 |
| 1437199973 | Jonathan Fisher | Emergency Medicine | One Deaconess Rd, Bidmc- Department of Emergency Medicine, Wcc2, Boston, MA 02215 | 2006-06-06 |
| 1043218282 | Jonathan Fisher | Physician Assistant | 85 Broad Street, Lobby Level, New York, NY 10004 | 2005-07-12 |
| 1447880216 | Jonathan Fisher | Case Manager/Care Coordinator | 6942 Tylersville Rd, West Chester, OH 45069-1511 | 2020-01-21 |
| 1578124863 | Jonathan Ming-yan Fisher | Student in an Organized Health Care Education/Training Program | 1720 E Cesar E Chavez Ave, Los Angeles, CA 90033-2414 | 2019-06-26 |
| 1295232403 | Jonathan Fisher | Counselor | 923 S Church St, Grapevine, TX 76051-5526 | 2018-04-12 |
| 1316005382 | Jonathan Fisher | Registered Nurse | 975 E Third St, Chattanooga, TN 37403-2147 | 2006-12-04 |
| 1073520276 | Jonathan Aaron Fisher | Physical Therapist | 2775 Schoenersville Rd, Bethlehem, PA 18017-7307 | 2006-08-01 |
| Street Address |
30544 HIGHWAY 200 SUITE 102 |
| City | PONDERAY |
| State | ID |
| Zip Code | 83852-5005 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780651539 | Bruce William Demko | Nurse Anesthetist, Certified Registered | 30544 Highway 200, Ponderay, ID 83852-5005 | 2006-03-01 |
| 1679110845 | Angela Alice Chapin | Massage Therapist | 30544 Highway 200, Ponderay, ID 83852-5005 | 2019-12-05 |
| 1851894018 | Jessica Hunt | Massage Therapist | 30544 Highway 200, Ponderay, ID 83852-5005 | 2018-03-14 |
| 1235649625 | Kauai In-home Therapy LLC | Clinic/Center | 30544 Highway 200, Ponderay, ID 83852-5005 | 2017-10-11 |
| 1932527389 | Stuart Gall Crna Inc | Nurse Anesthetist, Certified Registered | 30544 Highway 200, Suite 201, Ponderay, ID 83852-5005 | 2014-04-02 |
| 1669756813 | Nichole Suzanne Grimm | Nurse Practitioner | 30544 Highway 200, Ste 101, Ponderay, ID 83852-5005 | 2011-10-06 |
| 1073757464 | Michael R Dibenedetto Md Pllc | Surgery | 30544 Highway 200, Suite 102, Ponderay, ID 83852-5005 | 2009-04-29 |
| 1376713008 | Bruce Demko Crna Inc | Nurse Anesthetist, Certified Registered | 30544 Highway 200, Ponderay, ID 83852-5005 | 2008-03-10 |
| 1821276353 | Pend Oreille Surgery Center LLC | Clinic/Center | 30544 Highway 200, Suite 201, Ponderay, ID 83852-5005 | 2008-02-06 |
| 1679644397 | Michael Raymond Dibenedetto | Orthopaedic Surgery | 30544 Highway 200, Ste 102, Ponderay, ID 83852-5005 | 2006-11-13 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346606647 | Vern Stairs | Pharmacist | 476999 Us-95, Walmart Supercenter, Ponderay, ID 83852 | 2016-01-04 |
| 1083809727 | Michael R Dibenedetto Md Pllc | Orthopaedic Surgery | 30544 Hwy 200, Ste 102, Ponderay, ID 83852 | 2007-09-06 |
| 1811009988 | David Paul Cox | Dentist | 477542 Hwy 95 N, Ponderay, ID 83852 | 2006-08-31 |
| 1861774291 | Michael David Schicker | Orthopaedic Surgery | 30544 Highway 200 Ste 102, Ponderay, ID 83852 | 2011-09-12 |
| 1750410825 | Glacier Prosthetic Care, Inc. | Prosthetic/Orthotic Supplier | 205 Vermeer Dr, Suite C, Ponderay, ID 83852-1660 | 2007-03-05 |
| 1083949531 | Mario E Roxas | Naturopath | 476864 Highway 95, Suite #3, Ponderay, ID 83852-5000 | 2009-10-15 |
| 1942716246 | Darwin L Hurst | Family Medicine | 30544 Highway 200 Ste 101, Ponderay, ID 83852-5005 | 2017-12-21 |
| 1902036734 | Innovative Anesthesia | Nurse Anesthetist, Certified Registered | 30544 Highway 200 Ste 201, Pend Oreille Surgery Center, Ponderay, ID 83852-5005 | 2009-07-14 |
| 1255597811 | Travis Lee Taylor | Nurse Practitioner | 30544 Highway 200 Ste 102, Ponderay, ID 83852-5005 | 2008-08-04 |
| 1982741195 | Ryan Leisy | Chiropractor | 30544 Highway 200 Ste 330, Ponderay, ID 83852-5005 | 2007-01-30 |
| Find all providers in zip 83852 | ||||
| Taxonomy Code | 213ES0103X |
| Grouping | Podiatric Medicine & Surgery Service Providers |
| Classification | Podiatrist |
| Specialization | Foot & Ankle Surgery |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518225929 | Clark A Johnson | Podiatrist | 3120 W Belltower Dr Ste 100, Meridian, ID 83646-7744 | 2012-04-24 |
| 1396023446 | Kurt Earl Kinghorn | Podiatrist | 1828 S Millenium Way Ste 200, Meridian, ID 83642-5036 | 2011-07-22 |
| 1649506536 | James Rex Cutler | Podiatrist | 76 E 1st S, Rexburg, ID 83440-1936 | 2009-10-27 |
| 1174756316 | Daniel Matthew Wettstein | Podiatrist | 476 Cheney Drive West, Twin Falls, ID 83301 | 2009-09-03 |
| 1578576732 | Bruce G Tolman | Podiatrist | 1540 Elk Creek Dr, Idaho Falls, ID 83404-8322 | 2006-08-15 |
| 1679514186 | Ryan Averett Dpm PC | Podiatrist | 2221 W Ironwood Center Dr, Coeur D Alene, ID 83814-2697 | 2006-06-08 |
| 1245216647 | Kert W Howard | Podiatrist | 1555 E Clark St, Pocatello, ID 83201-4133 | 2005-12-16 |
| 1093717787 | Richard Michael Allen | Podiatrist | 1630 23rd Ave, Suite 1001, Lewiston, ID 83501-6350 | 2005-08-11 |
| 1447257076 | Bradley J Capawana | Podiatrist | 619 S Washington St, Ste 103, Moscow, ID 83843-3090 | 2005-06-28 |
| 1326042045 | Michael J Drager | Podiatrist | 850 W Ironwood Dr, Ste 301, Coeur D Alene, ID 83814-4903 | 2005-06-09 |
| Find all providers with the same taxonomy | ||||
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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.