Patricia Jordan Fast, D.M.D.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

8068 Issued in SC

Practice address

1507 Heritage LN
Suite a
Florence, SC 29505-3141

Phone

(843) 665-4477

NPI assigned

Jul 11, 2012

Last updated

Nov 17, 2016By the provider in NPPES

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

Other names 1

• Miss Patricia Louise Jordan Former name

Medicare fee-for-service enrollment

Enrolled in SC

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1341964800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1479340800000",
    "number": "1588929848",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "904 MOHAWK DR",
            "city": "FLORENCE",
            "state": "SC",
            "postal_code": "295015705",
            "telephone_number": "843-269-4266"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1507 HERITAGE LN",
            "address_2": "SUITE A",
            "city": "FLORENCE",
            "state": "SC",
            "postal_code": "295053141",
            "telephone_number": "843-665-4477"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAST",
        "first_name": "PATRICIA",
        "middle_name": "JORDAN",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-07-11",
        "last_updated": "2016-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "SC",
            "license": "8068",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "PATRICIA",
            "last_name": "JORDAN",
            "middle_name": "LOUISE",
            "prefix": "MISS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Familyties of SC, LLC
• William Victor Farnsworth, MD
• Howard A Farrell, MD
• Keith Alan Farrell, MS MPH APRN
• Morgan Farrell
• Brittany Fatica
• Lily Knight Fatula, MD
• Carl Alvin Faulks, M.D.
• Gabrielle Maritza-Yesenia Fauntleroy
• Brian Mark Feagin, OTRL, CHT

• General Practice Dentistry in Florence, SC
• Providers in Florence, SC by specialty
• General Practice Dentistry in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.