NPIMap

Individual provider Active NPI

Nicholas J Dawson Fugate, DO

  • Family Medicine Physician
  • Pineville, KY
National Provider Identifier
1477058071
Registry record updated Feb 3, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
04947 Issued in KY
Practice address
313 S Cherry St
Pineville, KY 40977-1724
Phone
(606) 654-3338
Fax
(606) 654-2273
NPI assigned
Mar 26, 2018
Last updated
Feb 3, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 3, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X KY
Family Medicine Physician 207Q00000X 04947 KY Primary

Addresses

Primary practice location

313 S Cherry St
Pineville, KY 40977-1724

Mailing address

424 W Tennessee Ave
Pineville, KY 40977-1438
Phone (606) 337-3223

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210913003007 KY Practitioner - Family Practice 1557767779 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

313 S Cherry St
Pineville, KY 40977-1724
Phone (606) 654-3338

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

Practice roles

OrganizationSpecialtyStatusNew patients
Grace Community Health Center, Inc. CurrentSince Aug 28, 2021 Accepting new patients
Grace Community Health Center, Inc. Family Medicine CurrentSince Aug 28, 2021 Accepting new patients

Locations

1019 Cumberland Falls Hwy
Ste B201
Corbin, KY 40701

14662 N US Highway 25 E
Corbin, KY 40701
Phone (606) 526-9005

39 Cumberland Gap Plz
Gray, KY 40734
Phone (606) 526-9005

21154 Highway 421
Ste 1
Hyden, KY 41749

272 London Mountain View Dr
London, KY 40741
Phone (606) 231-2614

85 Highway 80
Manchester, KY 40962
Phone (606) 596-0410

313 S Cherry St
Pineville, KY 40977
Phone (606) 654-3338

Interoperability endpoints

  • Direct secure messaging: nfugate704335@direct.ochin.org

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 6

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1522022400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643846400000",
    "number": "1477058071",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "424 W TENNESSEE AVE",
            "city": "PINEVILLE",
            "state": "KY",
            "postal_code": "409771438",
            "telephone_number": "606-337-3223"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "313 S CHERRY ST",
            "city": "PINEVILLE",
            "state": "KY",
            "postal_code": "409771724",
            "telephone_number": "606-654-3338",
            "fax_number": "606-654-2273"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FUGATE",
        "first_name": "NICHOLAS",
        "middle_name": "J DAWSON",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-03-26",
        "last_updated": "2022-02-03",
        "certification_date": "2022-02-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "KY",
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "KY",
            "license": "04947",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pineville, KY

Sources for this page

Verify at the official NPI Registry.