SHELLEY FOGT (NPI# 1861856015) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1861856015 |
| Entity Type | Individual |
| Full Name | SHELLEY FOGT |
| Practice Address |
1220 E Elm St Ste 106 Lima OH 45804-2803 |
| Mailing Address |
1001 Bellefontaine Ave Lima OH 45804-2800 |
| Practice Telephone | 4192265180 |
| Practice Fax Number | 4199984517 |
| Mailing Telephone | 4199984575 |
| Mailing Fax Number | 4199984586 |
| Enumeration Date | 2016-04-13 |
| Last Update Date | 2020-09-17 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
APRN.CNP.18696 | OH | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
1220 E ELM ST STE 106 |
| City | LIMA |
| State | OH |
| Zip Code | 45804-2803 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134729817 | Luke Holliday | Pharmacist | Sams Club Pharmacy, 1150 Greely Chapel Rd, Lima, OH 45804 | 2020-10-30 |
| 1306482393 | Olympia Monik Johnson | Case Manager/Care Coordinator | 799 S. Main St, Lima, OH 45804 | 2019-11-25 |
| 1982260139 | Jenna Renee Warnecke | Speech-Language Pathologist | Shawnee Manor, 2535 Fort Amanda Rd, Lima, OH 45804 | 2019-05-14 |
| 1942728282 | Premier Care of Ohio, LLC. | Community/Behavioral Health | 2727 St. Johns Rd, Ste D, Lima, OH 45804 | 2017-09-07 |
| 1093250078 | Gevette Love | Counselor | 311 E. Market St., Lima, OH 45804 | 2016-12-29 |
| 1134595416 | Rewa A Banks | Nurse Practitioner | 2895 Harding Hwy Ste C, Lima, OH 45804 | 2015-08-20 |
| 1295148195 | Adaptive Medical Marketing, Inc | Durable Medical Equipment & Medical Supplies | 1378 Bellefontaine Ave, Lima, OH 45804 | 2014-06-09 |
| 1265771869 | Laura B Hile | Nurse Practitioner | 1875 South Dixie Highway, Lima, OH 45804 | 2013-02-04 |
| 1184960593 | Jenna L Kimmel | Nurse Practitioner | 799 S. Main St., Lima, OH 45804 | 2012-12-13 |
| 1437398054 | Champaign Residential Services, Inc. | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 2450 Mandolin Drive, Lima, OH 45804 | 2009-02-05 |
| Find all providers in zip 45804 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730713967 | Internal Medicine Primary Care Incorporated | Nurse Practitioner | 920 W Market St Ste 210a, Lima, OH 45805-2777 | 2020-02-26 |
| 1770129835 | Kimberly Anne Stump | Nurse Practitioner | 690 Gardenview Cir, Lima, OH 45801-3873 | 2019-11-25 |
| 1104478098 | Anne Marie Sielschott | Nurse Practitioner | 830 W High St Ste 250, Lima, OH 45801-3981 | 2019-07-11 |
| 1982128328 | Wendy Shutler | Nurse Practitioner | 770 W High St Ste 220, Lima, OH 45801-5910 | 2017-07-27 |
| 1881116416 | Jaclyn Goins | Nurse Practitioner | 825 S Cable Rd Ste A, Lima, OH 45805-3467 | 2017-07-14 |
| 1760931034 | Denise Harris | Nurse Practitioner | 240 W Northern Ave, Suite 3, Lima, OH 45801-2839 | 2016-09-28 |
| 1134595416 | Rewa A Banks | Nurse Practitioner | 2895 Harding Hwy Ste C, Lima, OH 45804 | 2015-08-20 |
| 1871849828 | Ashton J. Crook | Nurse Practitioner | 3224 Jarvis Drive, Lima, OH 45807 | 2012-07-27 |
| 1740587823 | Katherine Hoying | Nurse Practitioner | 240 W Northern Ave Ste 3, Lima, OH 45801-2839 | 2011-02-25 |
| 1427298082 | Christy L Kretzer | Nurse Practitioner | 280 S Mcclure Rd, Lima, OH 45801-9711 | 2009-02-23 |
| Find all providers in LIMA | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.