Individual provider Active NPI

Jaime Fritsch, DACM, L.AC.

  • Acupuncturist
  • Mineral Bluff, GA
National Provider Identifier
1003650243
Registry record updated Jun 24, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
AcupuncturistTaxonomy code 171100000X
License
19699 Issued in CA
Practice address
857 Mountain Rivers LN
Mineral Bluff, GA 30559-7922
Phone
(619) 751-6904
NPI assigned
Jun 22, 2024
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 24, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acupuncturist 171100000X 19699 CA Primary

Addresses

Primary practice location

857 Mountain Rivers LN
Mineral Bluff, GA 30559-7922

Mailing address

857 Mountain Rivers LN
Mineral Bluff, GA 30559-7922
Phone (619) 751-6904

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
19699CAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Mountain Over Earth LLC Acupuncturist CurrentSince Dec 15, 2024 Accepting new patients

Locations

112 Professional Rd
Ste 1
Blue Ridge, GA 30513
Phone (619) 751-6904

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1719014400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719187200000",
    "number": "1003650243",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "857 MOUNTAIN RIVERS LN",
            "city": "MINERAL BLUFF",
            "state": "GA",
            "postal_code": "305597922",
            "telephone_number": "619-751-6904"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "857 MOUNTAIN RIVERS LN",
            "city": "MINERAL BLUFF",
            "state": "GA",
            "postal_code": "305597922",
            "telephone_number": "619-751-6904"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FRITSCH",
        "first_name": "JAIME",
        "name_prefix": "Dr.",
        "credential": "DACM, L.AC.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-06-22",
        "last_updated": "2024-06-24",
        "certification_date": "2024-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "CA",
            "license": "19699",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mineral Bluff, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.