Individual provider Active NPI

Jessica Thi Nguyen-Fisher, APRN

  • Pediatric Nurse Practitioner
  • Charleston, SC
National Provider Identifier
1689063612
Registry record updated Jan 15, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
18984 Issued in SC
Practice address
171 Ashley Ave
Charleston, SC 29425-8908
Phone
(843) 792-1414
NPI assigned
Jan 14, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 15, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X 18984 SC Primary

Addresses

Primary practice location

171 Ashley Ave
Charleston, SC 29425-8908

Mailing address

PO Box 751461
Charlotte, NC 28275-1461
Phone (843) 792-6200

Medicare participation

Medicare enrollment files
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: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150311002491 SC Practitioner - Nurse Practitioner 2961728811 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
18984SCMDPain Medicine (Anesthesiology) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University Medical Associates of the Medical University of South Carol Current Accepting new patients
University Medical Associates of the Medical University of South Carol CurrentSince Jan 15, 2015 Accepting new patients
University Medical Associates of the Medical University of South Carol CurrentSince Jan 15, 2015 Accepting new patients
University Medical Associates Past Accepting new patients

Locations

10 McClennan Banks Dr
Charleston, SC 29401
Phone (843) 330-9824

171 Ashley Ave
Charleston, SC 29425
Phone (843) 792-2123

4330 Ladson Rd
Ladson, SC 29456
Phone (843) 876-2222

2705 N Highway 17
#100
Mt Pleasant, SC 29466
Phone (615) 481-0418

2250 Mall Dr
North Charleston, SC 29406
Phone (843) 876-0199

Interoperability endpoints

  • Direct secure messaging: jnguyenfisher175436@direct.musc.edu

Organizations & group practices 4

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": "1421193600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1421280000000",
    "number": "1689063612",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 751461",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282751461",
            "telephone_number": "843-792-6200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "171 ASHLEY AVE",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294258908",
            "telephone_number": "843-792-1414"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NGUYEN-FISHER",
        "first_name": "JESSICA",
        "middle_name": "THI",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-01-14",
        "last_updated": "2015-01-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "SC",
            "license": "18984",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charleston, SC

Sources for this page

Verify at the official NPI Registry.