Active NPI
Angela R Fitzpatrick, DDS
- Dentist
- Charleston AFB, SC
National Provider Identifier
1871785113
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 6160-015
- Practice address
- 204 W Hill Blvd
BLDG 364
Charleston AFB, SC 29404-4704 - Phone
- (843) 963-6879
- NPI assigned
- Aug 10, 2007
- Last updated
- Oct 16, 2008
- 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 |
|---|---|---|---|---|
| Dentist | 122300000X | 6160-015 | WI | Primary |
Addresses
Primary practice location
204 W Hill Blvd
BLDG 364
Charleston AFB, SC 29404-4704
Mailing address
204 W Hill Blvd
BLDG 364
Charleston AFB, SC 29404-4704
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 |
|---|---|---|---|
| 6160-015 | WI | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1186704000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1224115200000",
"number": "1871785113",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "204 W HILL BLVD",
"address_2": "BLDG 364",
"city": "CHARLESTON AFB",
"state": "SC",
"postal_code": "294044704"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "204 W HILL BLVD",
"address_2": "BLDG 364",
"city": "CHARLESTON AFB",
"state": "SC",
"postal_code": "294044704",
"telephone_number": "843-963-6879"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FITZPATRICK",
"first_name": "ANGELA",
"middle_name": "R",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-08-10",
"last_updated": "2008-10-16",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "WI",
"license": "6160-015",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Charleston AFB, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.