Individual provider Active NPI

Duane Douglas Fitch, MD

  • Gastroenterology Physician
  • Wilson, NC
National Provider Identifier
1972688737
Registry record updated Dec 5, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
25997 Issued in NC
Practice address
2402 Camden St SW
Suite 300
Wilson, NC 27893-8608
Phone
(252) 237-4100
Fax
(252) 237-8449
NPI assigned
Oct 27, 2006
Last updated
Dec 5, 2011By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 5, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X 25997 NC Primary

Addresses

Primary practice location

2402 Camden St SW
Suite 300
Wilson, NC 27893-8608

Mailing address

PO Box 3526
Wilson, NC 27895-3526
Phone (252) 237-4100

Other identifiers 2

IdentifierTypeStateIssuer
890202FMedicaidNC
0202FOtherNCBLUE CROSS & BLUE SHIELD

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090306000235 NC Practitioner - Gastroenterology 5799841326

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
25997NCMDGastroenterology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Raleigh Medical Group, PA Gastroenterology CurrentSince Jan 30, 2019 Accepting new patients

Locations

3521 Haworth Dr
Raleigh, NC 27609
Phone (919) 782-1806

2402 Camden St SW
Ste 200
Wilson, NC 27893
Phone (252) 237-4100

2402 Camden St SW
Ste 300
Wilson, NC 27893
Phone (252) 237-4100

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.

NPI Registry JSON

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

{
    "created_epoch": "1161907200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1323043200000",
    "number": "1972688737",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3526",
            "city": "WILSON",
            "state": "NC",
            "postal_code": "278953526",
            "telephone_number": "252-237-4100",
            "fax_number": "252-237-8449"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2402 CAMDEN ST SW",
            "address_2": "SUITE 300",
            "city": "WILSON",
            "state": "NC",
            "postal_code": "278938608",
            "telephone_number": "252-237-4100",
            "fax_number": "252-237-8449"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FITCH",
        "first_name": "DUANE",
        "middle_name": "DOUGLAS",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-27",
        "last_updated": "2011-12-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "NC",
            "license": "25997",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "890202F",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS & BLUE SHIELD",
            "identifier": "0202F",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wilson, NC

Sources for this page

Verify at the official NPI Registry.