NPIMap

Individual provider Active NPI

Robert Blake Fugatt Jr., M.D.

  • Diagnostic Radiology Physician
  • Charleston, SC
National Provider Identifier
1497320378
Registry record updated Jul 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
85902 Issued in SC
Practice address
169 Ashley Ave RM 202
Charleston, SC 29425-8905
Phone
(843) 876-7081
NPI assigned
May 24, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 11, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 85902 SC
Diagnostic Radiology Physician 2085R0202X 85902 SC Primary

Addresses

Primary practice location

169 Ashley Ave RM 202
Charleston, SC 29425-8905

Mailing address

169 Ashley Ave RM 202
Charleston, SC 29425-8905
Phone (843) 876-7081

Other practice location 1

1325 Spring St
Greenwood, SC 29646-3860
Phone (864) 725-4111

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC, GA, TN, NC4 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 4

Enrollment IDStateProvider typePAC IDDetails
I20250701000293 SC Practitioner - Diagnostic RadiologyPractitioner - Family Practice 2163828138 Reassigns benefits to 4 organizations
I20260406002364 GA Practitioner - Diagnostic Radiology 2163828138 Reassigns benefits to 1 organization
I20260421002909 TN Practitioner - Diagnostic Radiology 2163828138 Reassigns benefits to 1 organization
I20260513000582 NC Practitioner - Diagnostic Radiology 2163828138 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
University of Tennessee, HSC, College of Medicine, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Musc Community PhysiciansGroup PAC ID 6507260668, 1,353 clinicians
Self Medical GroupGroup PAC ID 6002953916, 393 clinicians

Practice addresses (Care Compare)

120 Gateway Corp Blvd
Columbia, SC 29203-9611
Phone (803) 432-4311

1325 Spring St
Greenwood, SC 29646-3860
Phone (864) 725-4111

2435 Forest Dr
Columbia, SC 29204-2026
Phone (803) 256-5300

2750 Laurel St
Suite 104
Columbia, SC 29204-2036
Phone (843) 792-1414

4070 Hwy 17
Murrells Inlet, SC 29576-5033
Phone (843) 652-1000

4181 Hwy 17
Murrells Inlet, SC 29576-5019
Phone (843) 520-8881

506 N St
Bamberg, SC 29003-1319
Phone (803) 245-6290

606 Black River Rd
Georgetown, SC 29440-3304
Phone (843) 792-1414

710 Dewitt Dr
Lugoff, SC 29078-9069
Phone (803) 438-7566

Hospital & facility affiliations

  • Tidelands Waccamaw Community Hospital Hospital, Murrells Inlet, SC, CCN 420098
  • Musc Health Columbia Medical Center Downtown Hospital, Columbia, SC, CCN 420026
  • Tidelands Georgetown Memorial Hospital Hospital, Georgetown, SC, CCN 420020
  • Musc Health Florence Medical Center Hospital, Florence, SC, CCN 420091
  • Kershawhealth Hospital, Camden, SC, CCN 420048

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
University Medical Associates of the Medical University of South Carol Family Medicine CurrentSince Apr 1, 2026 Accepting new patients
Musc Community Physicians CurrentSince Feb 1, 2026 Accepting new patients
Self Medical Group Current Accepting new patients
Tidelands Health Market Common LLC CurrentSince Jan 1, 2026 Accepting new patients
Self Medical Group Diagnostic Radiology CurrentSince Jun 1, 2025 Accepting new patients
Tidelands and Medquest Joint Venture, LLC CurrentSince Jan 1, 2026 Accepting new patients
Musc Community Physicians Diagnostic Radiology CurrentSince Feb 1, 2026 Accepting new patients
University Medical Associates of the Medical University of South Carol CurrentSince Apr 1, 2026 Accepting new patients

Locations

75 Remittance Dr
Dept 6764
Chicago, IL 60675

1 Poston Rd
Ste 110
Charleston, SC 29407
Phone (843) 876-1347

171 Ashley Ave
Charleston, SC 29425
Phone (843) 792-2123

169 Ashley Ave
Rm 202
Charleston, SC 29425
Phone (843) 792-0192

1325 Spring St
Greenwood, SC 29646
Phone (864) 227-4111

2605 Kinard St
Ste 200
Newberry, SC 29108
Phone (803) 276-1866

Organizations & group practices 18

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.

View all 18

Hospital & facility affiliations 10

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": "1621814400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1752192000000",
    "number": "1497320378",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "169 ASHLEY AVE RM 202",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294258905",
            "telephone_number": "843-876-7081"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "169 ASHLEY AVE RM 202",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294258905",
            "telephone_number": "843-876-7081"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1325 Spring St",
            "address_purpose": "LOCATION",
            "city": "Greenwood",
            "state": "SC",
            "postal_code": "296463860",
            "country_code": "US",
            "telephone_number": "864-725-4111",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FUGATT",
        "first_name": "ROBERT",
        "middle_name": "BLAKE",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-05-24",
        "last_updated": "2025-07-11",
        "certification_date": "2025-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "SC",
            "license": "85902",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "SC",
            "license": "85902",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charleston, SC

Sources for this page

Verify at the official NPI Registry.