Patti E Busser

Key facts

NPI

1164046520

Entity type

Individual (NPI type 1)

Primary specialty

Social Worker 104100000X

License

010701 (CT)

Practice address

420 Polifka Dr
Shaw Afb, SC 29152-5100

Phone

(803) 895-6095

NPI assigned

Jun 2, 2020

Sex

Female

Sole proprietor

No

Medicare participation

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)

No

State licenses

Specialties & licenses

Addresses

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Aug 21, 2025.

{
    "created_epoch": "1591056000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1755734400000",
    "number": "1164046520",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "420 POLIFKA DR",
            "city": "SHAW AFB",
            "state": "SC",
            "postal_code": "291525100",
            "telephone_number": "803-895-6095"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "420 POLIFKA DR",
            "city": "SHAW AFB",
            "state": "SC",
            "postal_code": "291525100",
            "telephone_number": "803-895-6095"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUSSER",
        "first_name": "PATTI",
        "middle_name": "E",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-06-02",
        "last_updated": "2025-08-21",
        "certification_date": "2025-08-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "CT",
            "license": "010701",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Shaw Afb, SC

• Eric Black, IDMT
• Daniel Anthony Blaz, FNP-BC
• Elizabeth Ann Bowman, DDS
• Crystal Marie Boyle, LCSW
• Kyra Brooks, FNP-C
• Anna Marie Captain, DDS
• Rodrigo Carrasco
• Kelly Carter, RN
• Michael Chado, MD
• Ana N Chavis, PHARMD

All providers in Shaw Afb, SC · Social Worker in South Carolina