Theresa Fogal

Primary specialty

Respite CareTaxonomy code 385H00000X

Practice address

4310 Toro CT
Reno, NV 89502-6426

Phone

(775) 852-1078

NPI assigned

Aug 30, 2016

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

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.

• Theresa Fogal Dba Eagles Nest

  • Respite Care
  • Reno, NV
  • NPI 1023771300
  NPD Authorized official
• Eagles Nest Group Home

  • Respite Care
  • Reno, NV
  • NPI 1821451675
  NPD (past) Authorized official

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

{
    "created_epoch": "1472515200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1472515200000",
    "number": "1144776170",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4310 TORO CT",
            "city": "RENO",
            "state": "NV",
            "postal_code": "895026426",
            "telephone_number": "775-852-1078"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4310 TORO CT",
            "city": "RENO",
            "state": "NV",
            "postal_code": "895026426",
            "telephone_number": "775-852-1078"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FOGAL",
        "first_name": "THERESA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-08-30",
        "last_updated": "2016-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "385H00000X",
            "taxonomy_group": "",
            "desc": "Respite Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1821451675",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Flying Diamond Pharmacy LLC
• Ryan Fockler, MA
• Manase Foketi
• Danae Sheree Foley, APRN
• Lisa Kareen Foley, LCSW
• Donald Kurtis Folgner, DDS
• Gil Folk

• Respite Care in Reno, NV
• Providers in Reno, NV by specialty
• Respite Care in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 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.