Active NPI
Katherine Pate Pugh, RDH
- Dental Hygienist
- Fayetteville, NC
National Provider Identifier
1417090077
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dental Hygienist
- License
- 1767
- Practice address
- 2300 Ramsey St
Dental Service (160)
Fayetteville, NC 28301-3856 - Phone
- (910) 822-7029
- NPI assigned
- Feb 14, 2007
- Last updated
- Jul 8, 2007
- 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 |
|---|---|---|---|---|
| Dental Hygienist | 124Q00000X | 1767 | NC | Primary |
Addresses
Primary practice location
2300 Ramsey St
Dental Service (160)
Fayetteville, NC 28301-3856
Mailing address
4204 Kirkwood PL
Fayetteville, NC 28303-4919
Phone (910) 868-4008
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 |
|---|---|---|---|
| 1767 | NC | MD | Geriatric Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1171411200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1417090077",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4204 KIRKWOOD PL",
"city": "FAYETTEVILLE",
"state": "NC",
"postal_code": "283034919",
"telephone_number": "910-868-4008"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2300 RAMSEY ST",
"address_2": "DENTAL SERVICE (160)",
"city": "FAYETTEVILLE",
"state": "NC",
"postal_code": "283013856",
"telephone_number": "910-822-7029"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PUGH",
"first_name": "KATHERINE",
"middle_name": "PATE",
"name_prefix": "Mrs.",
"credential": "RDH",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-02-14",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "124Q00000X",
"taxonomy_group": "",
"desc": "Dental Hygienist",
"state": "NC",
"license": "1767",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fayetteville, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.