{"npi":"1407155666","type":"NPI-1","status":"active","name":{"display":"Dr. Keely Fischbach M.D.","other":[],"first":"KEELY","last":"FISCHBACH","middle":"ELIZABETH","credential":"M.D."},"specialty":{"primary_taxonomy":"207R00000X","primary_taxonomy_description":"Internal Medicine","slug":"internal-medicine","schema_org_specialty":"Internal","all":[{"code":"207R00000X","description":"Internal Medicine","primary":false,"state":"MI","license":"4301500649"},{"code":"207R00000X","description":"Internal Medicine","primary":false,"state":"OH","license":"35.134374"},{"code":"207R00000X","description":"Internal Medicine","primary":false,"state":"FL","license":"ME117183"},{"code":"207R00000X","description":"Internal Medicine","primary":false,"state":"IN","license":"01088492A"},{"code":"207R00000X","description":"Internal Medicine","primary":false,"state":"IL","license":"036.162510"},{"code":"207R00000X","description":"Internal Medicine","primary":true,"state":"VA","license":"0101273000"}]},"addresses":[{"purpose":"LOCATION","street_1":"1600 SW ARCHER RD","city":"GAINESVILLE","state":"FL","postal_code":"326108205","country_code":"US","phone":"3522948278","fax":"9043485627"},{"purpose":"MAILING","street_1":"PO BOX 44004","city":"JACKSONVILLE","state":"FL","postal_code":"322314004","country_code":"US","phone":"9042021032","fax":"9043485627"}],"license":{"state":"VA","number":"0101273000"},"identifiers":[{"type_code":"05","label":"Medicaid","value":"011168400","state":"FL","issuer":null},{"type_code":"01","label":"Other","value":"P01366911","state":"FL","issuer":"RAILROAD MEDICARE"}],"pecos":{"enrolled_at":"2026-05-09T10:41:39.028268+00:00","enrollments":[{"enrlmt_id":"I20140728002031","type_code":"14-08","type_desc":"PRACTITIONER - FAMILY PRACTICE","state":"FL","pac_id":"9436375409"},{"enrlmt_id":"I20190325002507","type_code":"14-11","type_desc":"PRACTITIONER - INTERNAL MEDICINE","state":"GA","pac_id":"9436375409"},{"enrlmt_id":"I20220126002904","type_code":"14-11","type_desc":"PRACTITIONER - INTERNAL MEDICINE","state":"OH","pac_id":"9436375409"},{"enrlmt_id":"I20220205000124","type_code":"14-11","type_desc":"PRACTITIONER - INTERNAL MEDICINE","state":"VA","pac_id":"9436375409"},{"enrlmt_id":"I20220412002073","type_code":"14-11","type_desc":"PRACTITIONER - INTERNAL MEDICINE","state":"NY","pac_id":"9436375409"},{"enrlmt_id":"I20220913002995","type_code":"14-11","type_desc":"PRACTITIONER - INTERNAL MEDICINE","state":"IN","pac_id":"9436375409"},{"enrlmt_id":"I20221216002670","type_code":"14-11","type_desc":"PRACTITIONER - INTERNAL MEDICINE","state":"IL","pac_id":"9436375409"},{"enrlmt_id":"I20221221002659","type_code":"14-11","type_desc":"PRACTITIONER - INTERNAL MEDICINE","state":"MO","pac_id":"9436375409"},{"enrlmt_id":"I20230509003137","type_code":"14-11","type_desc":"PRACTITIONER - INTERNAL MEDICINE","state":"MS","pac_id":"9436375409"},{"enrlmt_id":"I20230630000227","type_code":"14-11","type_desc":"PRACTITIONER - INTERNAL MEDICINE","state":"MI","pac_id":"9436375409"},{"enrlmt_id":"I20240115001959","type_code":"14-11","type_desc":"PRACTITIONER - INTERNAL MEDICINE","state":"AR","pac_id":"9436375409"},{"enrlmt_id":"I20241001000763","type_code":"14-11","type_desc":"PRACTITIONER - INTERNAL MEDICINE","state":"LA","pac_id":"9436375409"},{"enrlmt_id":"I20241014000724","type_code":"14-11","type_desc":"PRACTITIONER - INTERNAL MEDICINE","state":"TX","pac_id":"9436375409"}]},"enumeration_date":"2011-03-26","last_updated":"2023-07-20","_meta":{"source":"NPPES","snapshot_date":"2023-07-20","doc_url":"https://findmynpi.com/api"}}