Active NPI
Kathryn L Fick, MD
- Obstetrics & Gynecology Physician
- Shiprock, NM
National Provider Identifier
1508023797
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Obstetrics & Gynecology Physician
- License
- 47068
- Practice address
- US Hwy 491 North
Shiprock, NM 87420 - Phone
- (505) 368-6001
- Fax
- (505) 368-7011
- NPI assigned
- May 16, 2008
- 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 |
|---|---|---|---|---|
| Obstetrics & Gynecology Physician | 207V00000X | 47068 | AZ | Primary |
Addresses
Primary practice location
US Hwy 491 North
Shiprock, NM 87420
Mailing address
PO Box 160
Shiprock, NM 87420-0160
Phone (505) 368-6001
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 05500 | Medicaid | LA |
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)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| North Country Healthcare Inc | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Multi-Specialty Clinic/Center
- Flagstaff, AZ
- NPI 1053587261
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1210896000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1585699200000",
"number": "1508023797",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 160",
"city": "SHIPROCK",
"state": "NM",
"postal_code": "874200160",
"telephone_number": "505-368-6001",
"fax_number": "505-368-7011"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "US HWY 491 NORTH",
"city": "SHIPROCK",
"state": "NM",
"postal_code": "87420",
"telephone_number": "505-368-6001",
"fax_number": "505-368-7011"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FICK",
"first_name": "KATHRYN",
"middle_name": "L",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-05-16",
"last_updated": "2020-04-01",
"certification_date": "2020-04-01",
"status": "A"
},
"taxonomies": [
{
"code": "207V00000X",
"taxonomy_group": "",
"desc": "Obstetrics & Gynecology",
"state": "AZ",
"license": "47068",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "05500",
"state": "LA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Shiprock, NM
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.