NPIMap

Individual provider Active NPI

Courtney Fugate, NP

  • Nurse Practitioner
  • Pueblo, CO
National Provider Identifier
1962782037
Registry record updated May 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
APN.0996053-NP Issued in CO
Practice address
1301 E 7TH St
Pueblo, CO 81001-3508
Phone
(719) 543-8711
Fax
(719) 543-0171
NPI assigned
Aug 22, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 22, 2024

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X APN.0996053-NP CO Primary
Nurse Practitioner 363L00000X 3007065 KY
Hospitalist Physician 208M00000X C-APN.0000757-C-NP CO
Nurse Practitioner 363L00000X C-APN.0000757-C-NP CO

Addresses

Primary practice location

1301 E 7TH St
Pueblo, CO 81001-3508

Mailing address

110 E Routt Ave
Pueblo, CO 81004-2117
Phone (719) 543-8711

Other identifiers 1

IdentifierTypeStateIssuer
9000145670MedicaidCO

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170626000384 CO Practitioner - Nurse Practitioner 4587834338 Reassigns benefits to 2 organizations

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

Practice addresses (Care Compare)

1301 E 7TH St
Pueblo, CO 81001-3508
Phone (719) 543-8711

300 Colorado Ave
Pueblo, CO 81004-2006
Phone (719) 543-8711

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
APN.0996053-NPCOMDNurse Practitioner
3007065KYMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Pueblo Community Health Center Inc CurrentSince Apr 22, 2024 Accepting new patients
Pueblo Community Health Center Inc CurrentSince Apr 22, 2024 Accepting new patients
Pueblo Community Health Center Inc Current Accepting new patients
Baptist Physicians Lexington, Inc Nurse Practitioner Past Accepting new patients
Baptist Physicians Lexington, Inc Nurse Practitioner Past Accepting new patients
Pueblo Community Health Center Inc. Past Accepting new patients

Locations

300 Colorado Ave
Pueblo, CO 81004
Phone (719) 543-8718

110 E Routt Ave
Pueblo, CO 81004
Phone (719) 543-8718

900 W Orman Ave
Rm MT118
Pueblo, CO 81004
Phone 7195438711385

1301 E 7th St
Pueblo, CO 81001
Phone (719) 250-6314

400 W 16th St
Pueblo, CO 81003
Phone (719) 584-4000

Interoperability endpoints

  • Direct secure messaging: courtney.fugate.p1@direct.pueblochc.nextgenshare.com

Organizations & group practices 7

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.

Hospital & facility affiliations 7

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": "1313971200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716336000000",
    "number": "1962782037",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 E ROUTT AVE",
            "city": "PUEBLO",
            "state": "CO",
            "postal_code": "810042117",
            "telephone_number": "719-543-8711",
            "fax_number": "719-543-0171"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1301 E 7TH ST",
            "city": "PUEBLO",
            "state": "CO",
            "postal_code": "810013508",
            "telephone_number": "719-543-8711",
            "fax_number": "719-543-0171"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FUGATE",
        "first_name": "COURTNEY",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-08-22",
        "last_updated": "2024-05-22",
        "certification_date": "2024-05-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CO",
            "license": "APN.0996053-NP",
            "primary": true
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "KY",
            "license": "3007065",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "CO",
            "license": "C-APN.0000757-C-NP",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CO",
            "license": "C-APN.0000757-C-NP",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9000145670",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pueblo, CO

Sources for this page

Verify at the official NPI Registry.