Active NPI
Bruce Fischer, PH.D.
- Clinical Psychologist
- Longs, SC
National Provider Identifier
1366430746
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 1049
- Practice address
- 1026 Snowberry Dr
Longs, SC 29568-8120 - Phone
- (631) 946-1249
- NPI assigned
- Oct 11, 2005
- 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 |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 1049 | SC | Primary |
Addresses
Primary practice location
1026 Snowberry Dr
Longs, SC 29568-8120
Mailing address
1026 Snowberry Dr
Longs, SC 29568-8120
Phone (631) 946-1249
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
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1049 | SC | MD | Registered Dietitian |
| 007958 | NY | MD | Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1128988800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1199059200000",
"number": "1366430746",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1026 SNOWBERRY DR",
"city": "LONGS",
"state": "SC",
"postal_code": "295688120",
"telephone_number": "631-946-1249"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1026 SNOWBERRY DR",
"city": "LONGS",
"state": "SC",
"postal_code": "295688120",
"telephone_number": "631-946-1249"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FISCHER",
"first_name": "BRUCE",
"credential": "PH.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2005-10-11",
"last_updated": "2007-12-31",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "SC",
"license": "1049",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Longs, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 31, 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.