Individual provider Active NPI

Fagan J Fraser, RRT

  • General Care Registered Respiratory Therapist
  • Decatur, GA
National Provider Identifier
1023353760
Registry record updated Dec 6, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Care Registered Respiratory TherapistTaxonomy code 2279G1100X
License
002643 Issued in GA
Practice address
1670 Clairmont Rd
Decatur, GA 30033-4004
Phone
(404) 321-6111
NPI assigned
Dec 6, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 6, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Care Certified Respiratory Therapist 2278G1100X 1750 AL
General Care Registered Respiratory Therapist 2279G1100X 002643 GA Primary

Addresses

Primary practice location

1670 Clairmont Rd
Decatur, GA 30033-4004

Mailing address

1670 Clairmont Rd
Decatur, GA 30033-4004
Phone (404) 321-6111

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
1750ALMDPsychologist
002643GAMDGeneral Care Registered Respiratory Therapist

NPI Registry JSON

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

{
    "created_epoch": "1354752000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1354752000000",
    "number": "1023353760",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1670 CLAIRMONT RD",
            "city": "DECATUR",
            "state": "GA",
            "postal_code": "300334004",
            "telephone_number": "404-321-6111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1670 CLAIRMONT RD",
            "city": "DECATUR",
            "state": "GA",
            "postal_code": "300334004",
            "telephone_number": "404-321-6111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FRASER",
        "first_name": "FAGAN",
        "middle_name": "J",
        "credential": "RRT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-12-06",
        "last_updated": "2012-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2278G1100X",
            "taxonomy_group": "",
            "desc": "Respiratory Therapist, Certified, General Care",
            "state": "AL",
            "license": "1750",
            "primary": false
        },
        {
            "code": "2279G1100X",
            "taxonomy_group": "",
            "desc": "Respiratory Therapist, Registered, General Care",
            "state": "GA",
            "license": "002643",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Decatur, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 2012; 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.