Active NPI
Timothy Lee Fischer, DO
- Geriatric Medicine (Family Medicine) Physician
- Winston Salem, NC
National Provider Identifier
1003834136
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Geriatric Medicine (Family Medicine) Physician
- License
- 201500226
- Practice address
- 4692 Brownsboro Rd
Winston Salem, NC 27106-3410 - Phone
- (336) 251-1114
- NPI assigned
- Jul 17, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 6467 | AK | |
| Geriatric Medicine (Family Medicine) Physician | 207QG0300X | 348 | SC | |
| Geriatric Medicine (Family Medicine) Physician | 207QG0300X | 201500226 | NC | Primary |
Addresses
Primary practice location
4692 Brownsboro Rd
Winston Salem, NC 27106-3410
Mailing address
4692 Brownsboro Rd
Winston Salem, NC 27106-3410
Phone (336) 251-1114
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 003481 | Medicaid | SC |
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)
- Enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 348 | SC | MD | Clinical Psychologist |
| 6467 | AK | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| John E. Emmel, MD, PC | Geriatric Medicine | Past | Accepting new patients |
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.
-
- Geriatric Medicine (Family Medicine) Physician
- Charleston, SC
- NPI 1235263534
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153094400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1436745600000",
"number": "1003834136",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4692 BROWNSBORO RD",
"city": "WINSTON SALEM",
"state": "NC",
"postal_code": "271063410",
"telephone_number": "336-251-1114"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4692 BROWNSBORO RD",
"city": "WINSTON SALEM",
"state": "NC",
"postal_code": "271063410",
"telephone_number": "336-251-1114"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FISCHER",
"first_name": "TIMOTHY",
"middle_name": "LEE",
"name_prefix": "Dr.",
"credential": "DO",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-17",
"last_updated": "2015-07-13",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "AK",
"license": "6467",
"primary": false
},
{
"code": "207QG0300X",
"taxonomy_group": "",
"desc": "Family Medicine, Geriatric Medicine",
"state": "SC",
"license": "348",
"primary": false
},
{
"code": "207QG0300X",
"taxonomy_group": "",
"desc": "Family Medicine, Geriatric Medicine",
"state": "NC",
"license": "201500226",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "003481",
"state": "SC"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Winston Salem, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.