Jacqueline Rose Fugate

Primary specialty

Developmental TherapistTaxonomy code 222Q00000X

License

000079322 Issued in KY

Practice address

117 3Rd St
Hazard, KY 41701-2159

Phone

(606) 233-1943

NPI assigned

Sep 14, 2010

Last updated

Mar 25, 2014By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1284422400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1395705600000",
    "number": "1629386503",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "117 3RD ST",
            "city": "HAZARD",
            "state": "KY",
            "postal_code": "417012159",
            "telephone_number": "606-233-1943"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "117 3RD ST",
            "city": "HAZARD",
            "state": "KY",
            "postal_code": "417012159",
            "telephone_number": "606-233-1943"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FUGATE",
        "first_name": "JACQUELINE",
        "middle_name": "ROSE",
        "name_prefix": "Mrs.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-09-14",
        "last_updated": "2014-03-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "222Q00000X",
            "taxonomy_group": "",
            "desc": "Developmental Therapist",
            "state": "KY",
            "license": "000079322",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Frank Daniel Mongiardo M.D. P.S.C (Appalachian Regional Head & Neck Center)
• Benjamin Freeman, M.D.
• Raymond R Fryman
• Fugate Family Chiropractic PSC
• Fairlena Kaye Fugate, D.C.
• Jeffrey Fugate, APRN
• Kristen Rae Fugate, RN
• Layla J Fugate, LCSW
• Lisa Fugate
• Rebecka Fugate

• Developmental Therapist in Hazard, KY
• Providers in Hazard, KY by specialty
• Developmental Therapist in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.