NPIMap

Organization Active NPI

Dennis J Fisher, M.D., P.a.

  • Family Medicine Physician
  • Charleston, SC
National Provider Identifier
1881896728
Registry record updated Jul 17, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
8383 Issued in SC
Legal business name
DENNIS J FISHER, M.D., P.A.
Practice address
21 Gamecock Ave
Charleston, SC 29407-3368
Phone
(843) 763-9664
Fax
(843) 763-2949
NPI assigned
Jun 4, 2007
Last updated
Jul 17, 2007By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 17, 2007

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

Authorized official

Name
Dr. Dennis Jeffrey Fisher, M.D.NPI 1417997693
Title
Owner
Phone
(843) 763-9664

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X 8383 SC Primary

Addresses

Primary practice location

21 Gamecock Ave
Charleston, SC 29407-3368

Mailing address

21 Gamecock Ave
Charleston, SC 29407-3368
Phone (843) 763-9664

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120110000683 SC Part B Supplier - Clinic/Group Practice 0840466017 Receives reassigned benefits from 69 practitioners
8 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Aiken, SC; Summerville, SC; North Charleston, SC; Moncks Corner, SC; Lancaster, SC; Indian Land, SC; Goose Creek, SC; Edisto Island, SC…

Other NPIs on the same Medicare enrollment 6

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Locations

21 Gamecock Ave
Charleston, SC 29407
Phone (843) 568-8149

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1180915200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1184630400000",
    "number": "1881896728",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21 GAMECOCK AVE",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294073368",
            "telephone_number": "843-763-9664",
            "fax_number": "843-763-2949"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21 GAMECOCK AVE",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294073368",
            "telephone_number": "843-763-9664",
            "fax_number": "843-763-2949"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DENNIS J FISHER, M.D., P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-04",
        "last_updated": "2007-07-17",
        "status": "A",
        "authorized_official_last_name": "FISHER",
        "authorized_official_first_name": "DENNIS",
        "authorized_official_middle_name": "JEFFREY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "843-763-9664",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "SC",
            "license": "8383",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charleston, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.