Kelli Nicole Fogarty, RN

Primary specialty

Home Health Registered NurseTaxonomy code 163WH0200X

License

4704254681 Issued in MI

Practice address

2087 Hidden LN
Leonard, MI 48367-3225

Phone

(734) 624-9938

NPI assigned

Aug 12, 2010

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

Credentials

Registered Nurse

State licenses

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

{
    "created_epoch": "1281571200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1283212800000",
    "number": "1003121120",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "765 KESTREL RIDGE DR",
            "city": "SOUTH LYON",
            "state": "MI",
            "postal_code": "481782027",
            "telephone_number": "734-624-9938"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2087 HIDDEN LN",
            "city": "LEONARD",
            "state": "MI",
            "postal_code": "483673225",
            "telephone_number": "734-624-9938"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FOGARTY",
        "first_name": "KELLI",
        "middle_name": "NICOLE",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-08-12",
        "last_updated": "2010-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WH0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Home Health",
            "state": "MI",
            "license": "4704254681",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Megan Frances Branstner
• Carlene J Brockert, LMSW
• Campbells Personal Care Home #4, Inc.
• Caring Connections Counseling, LLC
• Crestwood Dental on the Lake, PLC
• Robert J Kanas, DDS
• Colleen M Klosterman, O.T.R.
• Amanda Partain
• Pamela Mary Phillips, MA, LLPC, NCC, SCL
• Lisa Schneider

• Home Health Registered Nurse in Leonard, MI
• Providers in Leonard, MI by specialty
• Home Health Registered Nurse in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2010; 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.