Active NPI
Andrew Daegan Fogarty
- Pharmacist
- New Haven, IN
National Provider Identifier
1114801180
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 26031396A
- Practice address
- 907 Lincoln Hwy W
New Haven, IN 46774-2141 - Phone
- (260) 493-3736
- NPI assigned
- Aug 4, 2025
- 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 |
|---|---|---|---|---|
| Pharmacist | 183500000X | 26031396A | IN | Primary |
Addresses
Primary practice location
907 Lincoln Hwy W
New Haven, IN 46774-2141
Mailing address
9912 Dupont Lakes Dr Apt 1B
Fort Wayne, IN 46825-7348
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 26031396A | IN | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Walgreen Co | Past | Accepting new patients | |
| Walgreen Co | Past | Accepting new patients |
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": "1754265600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1754265600000",
"number": "1114801180",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9912 DUPONT LAKES DR APT 1B",
"city": "FORT WAYNE",
"state": "IN",
"postal_code": "468257348"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "907 LINCOLN HWY W",
"city": "NEW HAVEN",
"state": "IN",
"postal_code": "467742141",
"telephone_number": "260-493-3736"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FOGARTY",
"first_name": "ANDREW",
"middle_name": "DAEGAN",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2025-08-04",
"last_updated": "2025-08-04",
"certification_date": "2025-08-01",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "IN",
"license": "26031396A",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in New Haven, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.