Individual provider Active NPI

Adam Simpson Fischer, PT, DPT

  • Physical Therapist
  • Culver, IN
National Provider Identifier
1831649680
Registry record updated Oct 5, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
006646 Issued in KY
Practice address
950 E Shore Dr
Culver, IN 46511-9120
Phone
(773) 580-5064
NPI assigned
Oct 5, 2016
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 5, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 006646 KY Primary

Addresses

Primary practice location

950 E Shore Dr
Culver, IN 46511-9120

Mailing address

950 E Shore Dr
Culver, IN 46511-9120
Phone (773) 580-5064

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210630000300 SC Practitioner - Physical Therapist in Private Practice 0749600583 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
W M Woodward MD PAGroup PAC ID 6507922093, 2 clinicians

Practice addresses (Care Compare)

1124 Sam Rittenberg Blvd
Suite 1
Charleston, SC 29407-3362
Phone (843) 556-3462

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
006646KYMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
W M Woodward, MD, PA Physical Therapist CurrentSince Jun 1, 2021 Accepting new patients

Locations

1124 Sam Rittenberg Blvd
Ste 1
Charleston, SC 29407
Phone (803) 556-3462

Organizations & group practices 1

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": "1475625600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1475625600000",
    "number": "1831649680",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "950 E SHORE DR",
            "city": "CULVER",
            "state": "IN",
            "postal_code": "465119120",
            "telephone_number": "773-580-5064"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "950 E SHORE DR",
            "city": "CULVER",
            "state": "IN",
            "postal_code": "465119120",
            "telephone_number": "773-580-5064"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FISCHER",
        "first_name": "ADAM",
        "middle_name": "SIMPSON",
        "name_prefix": "Dr.",
        "credential": "PT, DPT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-10-05",
        "last_updated": "2016-10-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "KY",
            "license": "006646",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Culver, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.