Elmer T. Gabbard Jr., DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

4876 Issued in KY

Practice address

101 Town and Country LN
Hazard, KY 41701-9524

Phone

(606) 435-7676

Fax

(606) 436-5139

NPI assigned

Feb 5, 2007

Last updated

Jan 15, 2020By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

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: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1170633600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1579046400000",
    "number": "1629117882",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 738",
            "city": "HAZARD",
            "state": "KY",
            "postal_code": "417020738",
            "telephone_number": "606-435-7676",
            "fax_number": "606-436-5139"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 TOWN AND COUNTRY LN",
            "city": "HAZARD",
            "state": "KY",
            "postal_code": "417019524",
            "telephone_number": "606-435-7676",
            "fax_number": "606-436-5139"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GABBARD",
        "first_name": "ELMER",
        "middle_name": "T.",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-05",
        "last_updated": "2020-01-15",
        "certification_date": "2020-01-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "KY",
            "license": "4876",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "60048766",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Layla J Fugate, LCSW
• Lisa Fugate
• Rebecka Fugate
• Taylor Brooke Fugate, APRN
• Amanda Marie Fuller, LPCC
• Wanda Gabbard
• Alicia Gaddis
• Christopher Gamble
• Cassandra Ann Garrett, DO
• Gastroenterology Associates of Hazard PSC

• General Practice Dentistry in Hazard, KY
• Providers in Hazard, KY by specialty
• General Practice Dentistry in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.