Active NPI
Duane Douglas Fitch, MD
- Gastroenterology Physician
- Wilson, NC
National Provider Identifier
1972688737
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Gastroenterology Physician
- License
- 25997
- 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, 2011
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 890202F | Medicaid | NC | |
| 0202F | Other | NC | BLUE 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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20090306000235 | NC | Practitioner - Gastroenterology | 5799841326 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 25997 | NC | MD | Gastroenterology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Raleigh Medical Group, PA | Gastroenterology | Current | 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.
-
- Gastroenterology Physician
- Wilson, NC
- NPI 1760413918
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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2011; 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.