Joshua Fogleman
Individual provider Active NPI Occupational Therapist · South Pittsburg, TN
NPI 1124435029 · NPPES record last updated Jul 13, 2014
Key facts
- NPI
- 1124435029
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Occupational Therapist 225X00000X
- License
- 4630 (TN)
- Practice address
- 201 E 10TH St
South Pittsburg, TN 37380-1497 - Phone
- (423) 837-7981
- NPI assigned
- Jul 13, 2014
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4630 | TN | MD | Occupational Therapist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 4630 | TN | Yes |
Addresses
Primary practice location
201 E 10TH St
South Pittsburg, TN 37380-1497
Mailing address
1029 John Hood Dr
Rockvale, TN 37153-4161
Other providers in South Pittsburg, TN
- Kassie M. Crabtree
- Crossroads Urgent Care PLLC
- Samantha Everhart Dutton
- Eyear Optical, Inc.
- Kristin M Flake
- John Robert Fox
- Tracy G Gartman
- Thomas Charles Helm
- Katie Elizabeth Henson
- Shana T Hilson
All providers in South Pittsburg, TN · Occupational Therapist in Tennessee
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 13, 2014. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.