NPIMap

Organization Active NPI

Fischer, Richards & Walker, PA

Doing business as Coastal Carolina Orthodontics

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Jacksonville, NC
National Provider Identifier
1053400853
Registry record updated Sep 18, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X
Legal business name
FISCHER, RICHARDS & WALKER, PA
Doing business as
Coastal Carolina Orthodontics
Practice address
17 Office Park Dr
Jacksonville, NC 28546-3219
Phone
(910) 353-5234
Fax
(910) 353-1999
NPI assigned
Oct 12, 2006
Last updated
Sep 18, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 18, 2023

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

Authorized official

Name
Dr. Todd Alan Fischer, DMD MSNPI 1548364631
Title
President of Corporation
Phone
(910) 353-5234

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthodontics and Dentofacial Orthopedics Dentistry 1223X0400X NU Primary

Addresses

Primary practice location

17 Office Park Dr
Jacksonville, NC 28546-3219

Mailing address

17 Office Park Dr
Jacksonville, NC 28546-3219
Phone (910) 353-5234

Other identifiers 6

IdentifierTypeStateIssuer
0237AOtherNCBLUE CROSS BLUE SHIELD OF NC
8902986MedicaidNC
526060MOREHEADCITYOtherUNITED CONCORDIA
863135JACKSONVILLEOtherUNITED CONCORDIA
02986OtherNCBLUE CROSS BLUE SHIELD NC
890237AMedicaidNC

Other names 1

  • Coastal Carolina Orthodontics Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1160611200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1694995200000",
    "number": "1053400853",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17 OFFICE PARK DR",
            "city": "JACKSONVILLE",
            "state": "NC",
            "postal_code": "285463219",
            "telephone_number": "910-353-5234",
            "fax_number": "910-353-1999"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17 OFFICE PARK DR",
            "city": "JACKSONVILLE",
            "state": "NC",
            "postal_code": "285463219",
            "telephone_number": "910-353-5234",
            "fax_number": "910-353-1999"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FISCHER, RICHARDS & WALKER, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-12",
        "last_updated": "2023-09-18",
        "certification_date": "2023-09-18",
        "status": "A",
        "authorized_official_last_name": "FISCHER",
        "authorized_official_first_name": "TODD",
        "authorized_official_middle_name": "ALAN",
        "authorized_official_title_or_position": "PRESIDENT OF CORPORATION",
        "authorized_official_telephone_number": "910-353-5234",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD MS"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD OF NC",
            "identifier": "0237A",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8902986",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED CONCORDIA",
            "identifier": "526060MOREHEADCITY",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED CONCORDIA",
            "identifier": "863135JACKSONVILLE",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD NC",
            "identifier": "02986",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "890237A",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Coastal Carolina Orthodontics",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Coastal Carolina Orthodontics",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Jacksonville, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2023; 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.