Tessa Daniel Fach, NP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

24885 Issued in SC

Practice address

102 W 8TH North St Ste B
Summerville, SC 29483-6656

Phone

(912) 237-1688

NPI assigned

Jun 7, 2021

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Nurse Practitioner

State licenses

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

{
    "created_epoch": "1623024000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623024000000",
    "number": "1407423676",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1030 STRIPED LN",
            "city": "JOHNS ISLAND",
            "state": "SC",
            "postal_code": "294559018",
            "telephone_number": "912-237-1688"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "102 W 8TH NORTH ST STE B",
            "city": "SUMMERVILLE",
            "state": "SC",
            "postal_code": "294836656",
            "telephone_number": "912-237-1688"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FACH",
        "first_name": "TESSA",
        "middle_name": "DANIEL",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-06-07",
        "last_updated": "2021-06-07",
        "certification_date": "2021-05-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "SC",
            "license": "24885",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://www.sweetgrassplasticsurgery.com",
            "affiliation": "N",
            "endpointDescription": "URL",
            "address_1": "102 W 8th North St Ste B",
            "city": "Summerville",
            "state": "SC",
            "country_code": "US",
            "postal_code": "294836656",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Family Nurse Practitioner in Summerville, SC
• Providers in Summerville, SC by specialty
• Family Nurse Practitioner in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 7, 2021; 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.