Nicholas J Dawson Fugate, DO
Individual provider Active NPI Family Medicine Physician · Pineville, KY
NPI 1477058071 · NPPES record last updated Feb 3, 2022
Key facts
- NPI
- 1477058071
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- 04947 (KY)
- Practice address
- 313 S Cherry St
Pineville, KY 40977-1724 - Phone
- (606) 654-3338
- Fax
- (606) 654-2273
- NPI assigned
- Mar 26, 2018
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 11
Hospital & facility affiliations 6
Medicare Care Compare profile
- Specialty
- Family Practice
- Education
- Other, 2015
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Grace Community Health Center, Inc.
Practice addresses (Care Compare)
313 S Cherry St
Pineville, KY 40977-1724
Phone (606) 654-3338
Hospital & facility affiliations
- Amedisys Home Health Care
- Middlesboro Arh Hospital
- Baptist Health Corbin
- Pineville Community Health Center, Inc
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in KY
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20210913003007 | KY | Practitioner - Family Practice | 1557767779 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 04947 | KY | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Grace Community Health Center, Inc. | Family Medicine | Current |
Accepting new patients |
| Grace Community Health Center, Inc. | Current |
Accepting new patients |
Locations
14662 N US Highway 25 E
Corbin, KY 40701
Phone (606) 526-9005
1019 Cumberland Falls Hwy
Ste B201
Corbin, KY 40701
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
- nfugate704335@direct.ochin.org
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | KY | ||
| Family Medicine Physician | 207Q00000X | 04947 | KY | Yes |
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
Other providers in Pineville, KY
- Ess of Pineville LLC
- Family Health Care Associates 5 Limited Liability Company
- Amanda Fleming
- Frakes Elementary School
- FRG Kentucky PSC
- Shawn Shadell Fugate
- Mary Jean Gambrel
- Chadwick E Gambrell
- Amanda Louanne Mills Gann
- Whitney Jeree Gann
All providers in Pineville, KY · Family Medicine Physician in Kentucky
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 3, 2022. 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.
- Order and Referring (CMS).
- 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.