Active NPI
Jeffrey S Fait
- Forensic Psychiatry Physician
- Lackland a F B, TX
National Provider Identifier
1104990225
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Forensic Psychiatry Physician
- License
- 46069-020
- Practice address
- 2200 Bergquist Dr Ste 1
Attn Credentials (CMC)
Lackland a F B, TX 78236-9908 - Phone
- (210) 292-7395
- NPI assigned
- Nov 20, 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Forensic Psychiatry Physician | 2084F0202X | 46069-020 | WI | Primary |
Addresses
Primary practice location
2200 Bergquist Dr Ste 1
Attn Credentials (CMC)
Lackland a F B, TX 78236-9908
Mailing address
8010 Foxwood Chase
San Antonio, TX 78254-2800
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 46069-020 | WI | MD | Forensic Psychiatry Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1163980800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1104990225",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8010 FOXWOOD CHASE",
"city": "SAN ANTONIO",
"state": "TX",
"postal_code": "782542800"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2200 BERGQUIST DR STE 1",
"address_2": "ATTN CREDENTIALS (CMC)",
"city": "LACKLAND A F B",
"state": "TX",
"postal_code": "782369908",
"telephone_number": "210-292-7395"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FAIT",
"first_name": "JEFFREY",
"middle_name": "S",
"name_prefix": "Dr.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-11-20",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "2084F0202X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Forensic Psychiatry",
"state": "WI",
"license": "46069-020",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lackland a F B, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.