Provider Demographics
NPI:1295784999
Name:FIELDS, ANDREW JONATHAN (DC, APRN)
Entity type:Individual
Prefix:DR
First Name:ANDREW
Middle Name:JONATHAN
Last Name:FIELDS
Suffix:
Gender:M
Credentials:DC, APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 530062
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30353-0062
Mailing Address - Country:US
Mailing Address - Phone:843-695-6071
Mailing Address - Fax:843-569-5879
Practice Address - Street 1:3930 DEVINE ST
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29205-2804
Practice Address - Country:US
Practice Address - Phone:803-274-6272
Practice Address - Fax:803-973-6627
Is Sole Proprietor?:No
Enumeration Date:2006-05-09
Last Update Date:2021-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC17853363LF0000X
SC2168111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC223847878OtherHMO
SC223847878OtherBCBS
SC223847878OtherCOMMERCIAL
SC223847878OtherPPO
SCNP2106Medicaid
SCU89170OtherMEDICARE UPIN
SCCH2168Medicaid
SCCH2168Medicaid
SCU89170OtherMEDICARE UPIN
SCU891707322Medicare PIN
SCP00132592OtherMEDICARE RAILROAD
SCU891707322Medicare PIN