Denise Rallis-Frutos, APN, DNP

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

22395 Issued in SC

Practice address

2101 Dutch Fork Rd
Chapin, SC 29036-7576

Phone

(910) 742-9243

Fax

(888) 746-1787

NPI assigned

Nov 7, 2019

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1573084800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1573084800000",
    "number": "1295370856",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O.BOX 30353-8622",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303538622",
            "telephone_number": "910-338-2885",
            "fax_number": "864-626-0412"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2101 DUTCH FORK RD",
            "city": "CHAPIN",
            "state": "SC",
            "postal_code": "290367576",
            "telephone_number": "910-742-9243",
            "fax_number": "888-746-1787"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RALLIS-FRUTOS",
        "first_name": "DENISE",
        "credential": "APN, DNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-11-07",
        "last_updated": "2019-11-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "SC",
            "license": "22395",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• All providers in Chapin, SC
• Psychiatric/Mental Health Nurse Practitioner in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 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.