NPIMap

Organization Active NPI

Fogg Remington Eyecare, Inc.

  • Optometrist
  • Clovis, CA
National Provider Identifier
1114989803
Registry record updated Apr 5, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
FOGG REMINGTON EYECARE, INC.
Practice address
1817 Shaw Ave
Suite 104
Clovis, CA 93611-4069
Phone
(559) 298-3600
Fax
(559) 298-6497
NPI assigned
Apr 6, 2006
Last updated
Apr 5, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 5, 2022

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

Authorized official

Name
Ms. Paula Pendley
Title
Credentialing
Phone
(559) 449-5011

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X CA Primary

Addresses

Primary practice location

1817 Shaw Ave
Suite 104
Clovis, CA 93611-4069

Mailing address

1360 E Herndon Ave
Suite 401
Fresno, CA 93720-3326
Phone (559) 449-5010

Other identifiers 1

IdentifierTypeStateIssuer
GSD004052MedicaidCA

National Provider Directory

National Provider Directory
Tax ID family
Fogg Maxwell Lanier MD8 organizations share this tax ID, including this one

Other organizations with this tax ID 7

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1144281600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1649116800000",
    "number": "1114989803",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1360 E HERNDON AVE",
            "address_2": "SUITE 401",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937203326",
            "telephone_number": "559-449-5010",
            "fax_number": "559-449-5014"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1817 SHAW AVE",
            "address_2": "SUITE 104",
            "city": "CLOVIS",
            "state": "CA",
            "postal_code": "936114069",
            "telephone_number": "559-298-3600",
            "fax_number": "559-298-6497"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FOGG REMINGTON EYECARE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-06",
        "last_updated": "2022-04-05",
        "certification_date": "2022-04-05",
        "status": "A",
        "authorized_official_last_name": "PENDLEY",
        "authorized_official_first_name": "PAULA",
        "authorized_official_title_or_position": "CREDENTIALING",
        "authorized_official_telephone_number": "559-449-5011",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GSD004052",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Clovis, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 2022; 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.