Individual provider Active NPI

Robert Graham Fitch, D.M.D.

  • General Practice Dentistry
  • Murray, KY
National Provider Identifier
1467654137
Registry record updated Jun 23, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
8482 Issued in KY
Practice address
1304 Johnson Blvd
Murray, KY 42071-2926
Phone
(270) 753-1691
NPI assigned
Jun 4, 2007
Last updated
Jun 23, 2008By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 23, 2008

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 8482 KY Primary
Dentist 122300000X 8482 KY

Addresses

Primary practice location

1304 Johnson Blvd
Murray, KY 42071-2926

Mailing address

1304 Johnson Blvd
Murray, KY 42071-2926
Phone (270) 753-1691

Other identifiers 1

IdentifierTypeStateIssuer
7100017970MedicaidKY

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

LicenseStateTypeSpecialty
8482KYMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1180915200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1214179200000",
    "number": "1467654137",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1304 JOHNSON BLVD",
            "city": "MURRAY",
            "state": "KY",
            "postal_code": "420712926",
            "telephone_number": "270-753-1691"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1304 JOHNSON BLVD",
            "city": "MURRAY",
            "state": "KY",
            "postal_code": "420712926",
            "telephone_number": "270-753-1691"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FITCH",
        "first_name": "ROBERT",
        "middle_name": "GRAHAM",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-06-04",
        "last_updated": "2008-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "KY",
            "license": "8482",
            "primary": true
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "KY",
            "license": "8482",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100017970",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Murray, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.