Fairlena Kaye Fugate, D.C.
Individual provider Active NPI Chiropractor · Hazard, KY
NPI 1285602011 · NPPES record last updated Jun 5, 2024
Key facts
- NPI
- 1285602011
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Chiropractor 111N00000X
- License
- 4580 (KY)
- Practice address
- 100 Veterans Dr
Hazard, KY 41701-9483 - Phone
- (606) 439-3399
- Fax
- (606) 487-9280
- NPI assigned
- Mar 9, 2006
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 2
Owned or controlled facilities with NPI records 2
Medicare Care Compare profile
- Specialty
- Chiropractic
- Education
- Other, 2000
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Fugate Family Chiropractic PSC
Practice addresses (Care Compare)
100 Veterans Dr
Hazard, KY 41701-9483
Phone (606) 439-3399
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in KY
All facility ownership & control disclosures 2
| Facility | Type | Role | Since |
|---|---|---|---|
| Bluegrass Home Health Care |
Home health agency | Corporate Director | Jan 1, 2024 |
| Mountain Community Hospice |
Hospice | Corporate Director | Jan 1, 2024 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20060118000228 | KY | Practitioner - Chiropractic | 9133104193 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| CH8163 | FL | MD | Chiropractor |
| 4580 | KY | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Family Center LLC | Current |
Accepting new patients | |
| Fugate Family Chiropractic PSC | Chiropractor | Current |
Accepting new patients |
Locations
100 Veterans Dr
Hazard, KY 41701
Phone (606) 439-3399
3123 N KY Highway 15
#1
Hazard, KY 41701
Phone (606) 439-3399
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | CH8163 | FL | |
| Chiropractor | 111N00000X | 4580 | KY | Yes |
Addresses
Primary practice location
100 Veterans Dr
Hazard, KY 41701-9483
Mailing address
100 Veterans Dr
Hazard, KY 41701-9483
Phone (606) 439-3399
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 85000412 | Medicaid | KY | |
| 000000175042 | Other | KY | ANTHEM BC/BS PIN NUMBER |
Other providers in Hazard, KY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 5, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.