Individual provider Active NPI

Heather R Fagen, PHARMD

  • Pharmacist
  • Rochester, NY
National Provider Identifier
1124340948
Registry record updated Sep 18, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
20053741 Issued in NY
Practice address
1433 Culver Rd
Rochester, NY 14609-4235
Phone
(585) 288-3000
NPI assigned
Feb 20, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 18, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 20053741 NY Primary

Addresses

Primary practice location

1433 Culver Rd
Rochester, NY 14609-4235

Mailing address

170 Sannita Dr
Rochester, NY 14626-3614
Phone (585) 455-3089

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
Credentials
Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
20053741NYMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1266624000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1474156800000",
    "number": "1124340948",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "170 SANNITA DR",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146263614",
            "telephone_number": "585-455-3089"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1433 CULVER RD",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146094235",
            "telephone_number": "585-288-3000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAGEN",
        "first_name": "HEATHER",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-02-20",
        "last_updated": "2016-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NY",
            "license": "20053741",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rochester, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2016; 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.