Active NPI
Vincent Michael Fitch, PSYD
- Psychologist
- Augusta, GA
National Provider Identifier
1104435718
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- Practice address
- 1 Freedom Way
Augusta, GA 30904-6258 - Phone
- (443) 542-7387
- NPI assigned
- Jul 29, 2020
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | Primary |
Addresses
Primary practice location
1 Freedom Way
Augusta, GA 30904-6258
Mailing address
529 W Buena Vista Ave
North Augusta, SC 29841-3639
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Jun 26, 2024 through Jun 26, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1595980800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1595980800000",
"number": "1104435718",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "529 W BUENA VISTA AVE",
"city": "NORTH AUGUSTA",
"state": "SC",
"postal_code": "298413639"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1 FREEDOM WAY",
"city": "AUGUSTA",
"state": "GA",
"postal_code": "309046258",
"telephone_number": "443-542-7387"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FITCH",
"first_name": "VINCENT",
"middle_name": "MICHAEL",
"credential": "PSYD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2020-07-29",
"last_updated": "2020-07-29",
"certification_date": "2020-07-29",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Augusta, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.