KASEY EAVENSON FISH (NP-C) – Family Nurse Practitioner, NPI 1558932004

KASEY EAVENSON FISH (NP-C) is a healthcare provider. based in Macon, Georgia. specializing in NURSE PRACTITIONER. They hold the professional credentials NP-C. They hold a License No. RN183098 (GA). The NPI Number for KASEY EAVENSON FISH (NP-C) is 1558932004

Main info

Female
5 Years Of Experience
Accepts Medicare Assignment
Name
KASEY EAVENSON FISH (NP-C)
NPI
1558932004
Phone
(478) 787-4266
Address
400 POPLAR ST
Enumeration Date
6 July 2021
Last Update Date
16 February 2026

Doctor Profile

Medical School Name
OTHER
Secondary Phone
4788257000
Graduation Year
2021 (5 years ago)
PAC ID
8628466281
Group Practice PAC ID
3375795693
Professional Enrollment ID
I20211101001523
Address ID
GA310305008FO201XXDRXX300
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience32
Completeness85
Years active:4State licenses:1Digital endpointsOther names

9,652 NURSE PRACTITIONER in GA

Provider Addresses for KASEY EAVENSON FISH (NP-C)

  • 400 POPLAR ST

    MACON, GA 312013336

    Phone: (478) 787-4266

    Fax: (478) 787-4199

    Type: Mailing

  • 701 BLUEBIRD BLVD

    FORT VALLEY, GA 310305085

    Phone: (478) 825-7000

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 41 Open Payments records for all available years, with a total value of $767.

Total Amount is formed as General ($767) + Research ($0) + Ownership ($0) = $767.

Last reported payment date: 2024-11-27 • Largest payer in this snapshot: Novo Nordisk Inc ($149).

Total Amount

$767

General + Research + Ownership

Payments

41

Total payment records

General Amount

$767

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-11-27

Latest reported date

Top Companies

Largest payers in this snapshot

View all Open Payments →|Open Payments Risk Radar →

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2021-11-01

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20211101001523INurse PractitionerGATBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 31201)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 3375795693View full group profile
NameSpecialtyState
Physician AssistantGA
Family PracticeGA

Reviews

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Frequently asked questions

What NPI should I save for KASEY EAVENSON FISH (NP-C)?
Save NPI 1558932004 if you need a stable reference for KASEY EAVENSON FISH (NP-C).
Is KASEY EAVENSON FISH (NP-C)'s enrollment marked active?
An active flag here means the NPI record is not in a deactivated state.
Can you summarize KASEY EAVENSON FISH (NP-C)'s specialty in plain language?
Clinically, the directory lists KASEY EAVENSON FISH (NP-C) with Family Nurse Practitioner. Clinical services aligned with this taxonomy classification.
Where is KASEY EAVENSON FISH (NP-C)'s primary listing?
We display Macon, Georgia because that is what the record indicates for KASEY EAVENSON FISH (NP-C).
Is this NPI for an individual or an organization?
This listing corresponds to an Individual Provider.

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