Individual provider Active NPI

Jeffrey Fugate, APRN

  • Family Nurse Practitioner
  • Hazard, KY
National Provider Identifier
1578843777
Registry record updated Oct 1, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
3007083 Issued in KY
Practice address
311 Roy Campbell Dr
Suite 100
Hazard, KY 41701-9486
Phone
(606) 487-7383
Fax
(606) 487-8374
NPI assigned
Aug 19, 2011
Last updated
Oct 1, 2021By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 1, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 3007083 KY Primary

Addresses

Primary practice location

311 Roy Campbell Dr
Suite 100
Hazard, KY 41701-9486

Mailing address

281 Terrace View Dr
Hazard, KY 41701-7882
Phone (606) 436-0711

Other practice location 1

59 Cowtown Rd
Hindman, KY 41822-9120
Phone (606) 785-3175

Other identifiers 1

IdentifierTypeStateIssuer
3007083OtherKYLICENSE NUMBER

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20111102000835 KY Practitioner - Nurse Practitioner 8729251954 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Kentucky Medical Services Foundation, IncGroup PAC ID 5698689909, 949 clinicians

Practice addresses (Care Compare)

750 Morton Blvd
Hazard, KY 41701-9469
Phone (606) 439-1559

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
85.77 of 100Reported as group
Quality
68.25
Promoting interoperability
100
Improvement activities
40
Cost
72.39

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Kentucky Medical Services Foundation, Inc CurrentSince Oct 1, 2021 Accepting new patients
North Fork Valley Community Health Board, Inc. Past Accepting new patients

Locations

101 Town and Country Ln
#100
Hazard, KY 41701
Phone (606) 439-1300

750 Morton Blvd
Hazard, KY 41701
Phone (606) 439-1559

59 Cowtown Rd
Hindman, KY 41822
Phone (606) 785-3175

2400 Greatstone Pt
Lexington, KY 40504
Phone (859) 257-9800

Interoperability endpoints

  • Direct secure messaging: jfugate133606@ukhcdirect.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 4

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": "1313712000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1633046400000",
    "number": "1578843777",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "281 TERRACE VIEW DR",
            "city": "HAZARD",
            "state": "KY",
            "postal_code": "417017882",
            "telephone_number": "606-436-0711",
            "fax_number": "606-436-0848"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "311 ROY CAMPBELL DR",
            "address_2": "SUITE 100",
            "city": "HAZARD",
            "state": "KY",
            "postal_code": "417019486",
            "telephone_number": "606-487-7383",
            "fax_number": "606-487-8374"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "59 Cowtown Rd",
            "address_purpose": "LOCATION",
            "city": "Hindman",
            "state": "KY",
            "postal_code": "418229120",
            "country_code": "US",
            "telephone_number": "606-785-3175",
            "fax_number": "606-785-9968",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FUGATE",
        "first_name": "JEFFREY",
        "credential": "APRN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-08-19",
        "last_updated": "2021-10-01",
        "certification_date": "2021-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "KY",
            "license": "3007083",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE NUMBER",
            "identifier": "3007083",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hazard, KY

Sources for this page

Verify at the official NPI Registry.