Individual provider Active NPI

Patrick Vincent Fischer, LMT

  • Massage Therapist
  • Myrtle Beach, SC
National Provider Identifier
1043552219
Registry record updated Mar 26, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
8064 Issued in SC
Practice address
4736 Highway 17 Byp S
Myrtle Beach, SC 29588-5616
Phone
(843) 444-9355
Fax
(843) 294-0019
NPI assigned
Mar 26, 2013
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 26, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Massage Therapist 225700000X 8064 SC Primary

Addresses

Primary practice location

4736 Highway 17 Byp S
Myrtle Beach, SC 29588-5616

Mailing address

189 Osprey Cove Loop
Myrtle Beach, SC 29588-6565
Phone (717) 587-8625

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
8064SCMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1364256000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1364256000000",
    "number": "1043552219",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "189 OSPREY COVE LOOP",
            "city": "MYRTLE BEACH",
            "state": "SC",
            "postal_code": "295886565",
            "telephone_number": "717-587-8625"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4736 HIGHWAY 17 BYP S",
            "city": "MYRTLE BEACH",
            "state": "SC",
            "postal_code": "295885616",
            "telephone_number": "843-444-9355",
            "fax_number": "843-294-0019"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FISCHER",
        "first_name": "PATRICK",
        "middle_name": "VINCENT",
        "credential": "LMT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-03-26",
        "last_updated": "2013-03-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "SC",
            "license": "8064",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Myrtle Beach, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2013; 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.