Individual provider Active NPI

Daniel Lee Fish, MD

  • Psychiatry Physician
  • Cary, NC
National Provider Identifier
1609223791
Registry record updated Aug 27, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
2018-00450 Issued in NC
Practice address
2000 Regency Pkwy Ste 255
Cary, NC 27518-8511
Phone
(704) 360-3637
Fax
(704) 323-5710
NPI assigned
May 18, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 27, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 2018-00450 NC Primary

Addresses

Primary practice location

2000 Regency Pkwy Ste 255
Cary, NC 27518-8511

Mailing address

PO Box 19305
Charlotte, NC 28219-9305

Other practice location 1

400 Northwood Dr
Centre, AL 35960-1023
Phone (256) 927-4900

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN, NC2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20230127000806 TN Practitioner - Psychiatry 7113219015 Reassigns benefits to 2 organizations
I20230322003052 NC Practitioner - Psychiatry 7113219015 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Integrative Wellness Solutions PLLCGroup PAC ID 8022341494, 143 clinicians

Practice addresses (Care Compare)

2000 Regency Pkwy
Suite 255
Cary, NC 27518-8511
Phone (704) 360-3637

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
2018-00450NCMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Cookeville Regional Medical Center CurrentSince Jan 2, 2023 Accepting new patients
Integrative Wellness Solutions, PLLC Psychiatry CurrentSince Oct 22, 2024 Accepting new patients
Cookeville Regional Medical Center CurrentSince Jan 2, 2023 Accepting new patients
Qler Physician Medical Group, P.a. Psychiatry PastSince Apr 29, 2018 Accepting new patients

Locations

2000 Regency Pkwy
Ste 255
Cary, NC 27518
Phone (888) 693-0435

10430 Harris Oak Blvd
Ste L
Charlotte, NC 28269
Phone (704) 317-2930

3625 N Elm St
Ste 130
Greensboro, NC 27455

1 Medical Center Blvd
Cookeville, TN 38501
Phone (931) 783-2334

140 W 7th St
Cookeville, TN 38501
Phone (931) 783-5582

Interoperability endpoints

  • Direct secure messaging: lifestancehealth.danielfish@146232.advancedmd-direct.com

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1463529600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724716800000",
    "number": "1609223791",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 19305",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282199305",
            "fax_number": "704-323-5710"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2000 REGENCY PKWY STE 255",
            "city": "CARY",
            "state": "NC",
            "postal_code": "275188511",
            "telephone_number": "704-360-3637",
            "fax_number": "704-323-5710"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "400 Northwood Dr",
            "address_purpose": "LOCATION",
            "city": "Centre",
            "state": "AL",
            "postal_code": "359601023",
            "country_code": "US",
            "telephone_number": "256-927-4900",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FISH",
        "first_name": "DANIEL",
        "middle_name": "LEE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-05-18",
        "last_updated": "2024-08-27",
        "certification_date": "2024-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NC",
            "license": "2018-00450",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cary, NC

Sources for this page

Verify at the official NPI Registry.