Individual provider Active NPI

Jeremy Ward Fike, D.D.S.

  • Endodontics
  • Abilene, TX
National Provider Identifier
1295000396
Registry record updated May 10, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
EndodonticsTaxonomy code 1223E0200X
License
26519 Issued in TX
Practice address
5849 Buffalo Gap Road
Suite C
Abilene, TX 79606
Phone
(325) 704-5001
NPI assigned
Mar 21, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 10, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Endodontics 1223E0200X 26519 TX Primary

Addresses

Primary practice location

5849 Buffalo Gap Road
Suite C
Abilene, TX 79606

Mailing address

5849 Buffalo Gap Road
Suite C
Abilene, TX 79606
Phone (325) 704-5001

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20171006002678 TX Order and Referring Only - DentistPractitioner - Dentist 6800116054

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
26519TXMDEndodontist

Practice roles

OrganizationSpecialtyStatusNew patients
Abilene Endodontics, PC Endodontics PastSince Jul 24, 2022 Accepting new patients

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": "1332288000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1557446400000",
    "number": "1295000396",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5849 BUFFALO GAP ROAD",
            "address_2": "SUITE C",
            "city": "ABILENE",
            "state": "TX",
            "postal_code": "79606",
            "telephone_number": "325-704-5001",
            "fax_number": "325-704-5141"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5849 BUFFALO GAP ROAD",
            "address_2": "SUITE C",
            "city": "ABILENE",
            "state": "TX",
            "postal_code": "79606",
            "telephone_number": "325-704-5001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FIKE",
        "first_name": "JEREMY",
        "middle_name": "WARD",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-03-21",
        "last_updated": "2019-05-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "TX",
            "license": "26519",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Abilene, TX

Sources for this page

Verify at the official NPI Registry.