Shana D Fogarty, M.D.

Primary specialty

Hospitalist PhysicianTaxonomy code 208M00000X

License

M8664 Issued in ID

Practice address

2003 Kootenai Health Way
Coeur D Alene, ID 83814-6051

Phone

(208) 625-5085

Fax

(208) 625-5731

NPI assigned

May 17, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in WA

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

Specialty

Family Practice

Education

University of Washington School of Medicine, 2001

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Northwest Hospital Medicine Physicians LLCGroup PAC ID 6406805449, 67 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Whidbeyhealth Hospice and Palliative Care Hospice, Coupeville, WA, CCN 501542
• Island Hospital Hospital, Anacortes, WA, CCN 500007

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

• Whidbey Island Public Hospital District

  • Community Based Hospice Care Agency
  • Coupeville, WA
  • NPI 1972776581

  Corporate Director, W-2 Managing Employee

  CMS ownership

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.

• Northwest Hospital Medicine Physicians LLC

  • Hospitalist Physician
  • Las Cruces, NM
  • NPI 1972056752

  WA

  Medicare reassignment Care Compare group NPD
• South Sound Inpatient Physicians PLLC

  • Internal Medicine Physician
  • Vancouver, WA
  • NPI 1023285756

  Family Medicine

  Medicare reassignment NPD
• Whidbey Island Public Hospital District

  • Critical Access Hospital
  • Coupeville, WA
  • NPI 1710927231
  Medicare reassignment NPD
• South Sound Inpatient Physicians PLLC

  • Internal Medicine Physician
  • Hillsboro, OR
  • NPI 1508023789

  Family Medicine

  NPD
• South Sound Inpatient Physicians, PLLC

  • Hospitalist Physician
  • Coupeville, WA
  • NPI 1982035754

  Family Medicine

  NPD
• Whidbey Island Public Hospital District

  • Diagnostic Radiology Physician
  • Mount Vernon, WA
  • NPI 1013538230
  NPD
• Whidbey Island Public Hospital District

  • Clinical Social Worker
  • Desert Hot Springs, CA
  • NPI 1518819341
  NPD
• Public Hospital District No 2 Skagit County Washington

  • General Acute Care Hospital
  • Anacortes, WA
  • NPI 1710913140
  NPD (past)
• Whidbey Island Public Hospital District

  • Community Based Hospice Care Agency
  • Coupeville, WA
  • NPI 1972776581

  Family Medicine

  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Public Hospital District No 2 Skagit County Washington

  • General Acute Care Hospital
  • Anacortes, WA
  • NPI 1710913140
  Care Compare affiliation
• Whidbey Island Public Hospital District

  • Community Based Hospice Care Agency
  • Coupeville, WA
  • NPI 1972776581
  Care Compare affiliation

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

{
    "created_epoch": "1147824000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1640131200000",
    "number": "1104879899",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2003 KOOTENAI HEALTH WAY",
            "city": "COEUR D ALENE",
            "state": "ID",
            "postal_code": "838146051",
            "telephone_number": "208-625-5085",
            "fax_number": "208-625-5731"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2003 KOOTENAI HEALTH WAY",
            "city": "COEUR D ALENE",
            "state": "ID",
            "postal_code": "838146051",
            "telephone_number": "208-625-5085",
            "fax_number": "208-625-5731"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FOGARTY",
        "first_name": "SHANA",
        "middle_name": "D",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-17",
        "last_updated": "2021-12-22",
        "certification_date": "2021-12-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WA",
            "license": "MD61238314",
            "primary": false
        },
        {
            "code": "207QH0002X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Hospice and Palliative Medicine",
            "state": "WA",
            "license": "MD61238314",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "WA",
            "license": "MD61238314",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "ID",
            "license": "M8664",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00204201",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Patrick W Flynn, CRNA
• Tia A Flynn, AUD
• FMG Ironwood Place Idaho LLC
• FMG West Lacrosse Avenue Idaho LLC
• Deanna M Fofanoff, LCPC
• Miranda Caroline Foley-Kekauoha, DOULA
• Gretchen Foley, PA-C
• Martina Folowell Nix
• Paul S Fontana, ARNP
• Charles B Fooe, MD

• Hospitalist Physician in Coeur D Alene, ID
• Providers in Coeur D Alene, ID by specialty
• Hospitalist Physician in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 22, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.