Active NPI
Deanna L Fisher, CDR
- Registered Dietitian
- Loris, SC
National Provider Identifier
1801086863
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 864105
- Practice address
- 3655 Mitchell St
Loris, SC 29569-9601 - Phone
- (843) 716-7000
- Fax
- (843) 716-7093
- NPI assigned
- Jul 26, 2007
- Last updated
- Jul 26, 2007
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | 864105 | SC | Primary |
Addresses
Primary practice location
3655 Mitchell St
Loris, SC 29569-9601
Mailing address
3655 Mitchell St., Box 690001
Loris, SC 29569-9601
Phone (843) 716-7000
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 864105 | Other | SC | CDR NUMBER |
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 864105 | SC | MD | Registered Dietitian |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1185408000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1185408000000",
"number": "1801086863",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3655 MITCHELL ST., BOX 690001",
"city": "LORIS",
"state": "SC",
"postal_code": "295699601",
"telephone_number": "843-716-7000",
"fax_number": "843-716-7093"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3655 MITCHELL ST",
"city": "LORIS",
"state": "SC",
"postal_code": "295699601",
"telephone_number": "843-716-7000",
"fax_number": "843-716-7093"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FISHER",
"first_name": "DEANNA",
"middle_name": "L",
"credential": "CDR",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-07-26",
"last_updated": "2007-07-26",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "SC",
"license": "864105",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CDR NUMBER",
"identifier": "864105",
"state": "SC"
}
],
"endpoints": [],
"other_names": []
}Other providers in Loris, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 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.