Nicole Patz, CPHT

Primary specialty

Pharmacy TechnicianTaxonomy code 183700000X

License

540107010168805

Practice address

550 Robertson Blvd
Walterboro, SC 29488-2788

Phone

(843) 549-3214

Fax

(843) 549-3216

NPI assigned

May 6, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1557100800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1557100800000",
    "number": "1114582038",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "550 ROBERTSON BLVD",
            "city": "WALTERBORO",
            "state": "SC",
            "postal_code": "294882788",
            "telephone_number": "843-549-3214",
            "fax_number": "843-549-3216"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "550 ROBERTSON BLVD",
            "city": "WALTERBORO",
            "state": "SC",
            "postal_code": "294882788",
            "telephone_number": "843-549-3214",
            "fax_number": "843-549-3216"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATZ",
        "first_name": "NICOLE",
        "name_prefix": "Mrs.",
        "credential": "CPHT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-05-06",
        "last_updated": "2019-05-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183700000X",
            "taxonomy_group": "",
            "desc": "Pharmacy Technician",
            "state": "SC",
            "license": "26690",
            "primary": false
        },
        {
            "code": "183700000X",
            "taxonomy_group": "",
            "desc": "Pharmacy Technician",
            "state": null,
            "license": "540107010168805",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHARMACY TECHNICIAN CERTIFICATION BOARD",
            "identifier": "5401-0701-0168-805",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SOUTH CAROLINA LABOR, LICENSING AND REGULATION",
            "identifier": "26690",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NABP",
            "identifier": "330558",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Palmetto Primary Care Physicians, LLC
• Palmetto Vision
• Walter Raphael Pangalangan, PT
• Regina Lynn Parker, CPSS, SAS
• Hemali Patel
• Peaches of Love
• Crystal Martina Perry
• Sarah Marie Peterson, PHARM.D.
• Peggy Murray Phalen, APRN
• Moya Pierce, RN

• Pharmacy Technician in Walterboro, SC
• Providers in Walterboro, SC by specialty
• Pharmacy Technician in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 2019; 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.