Mark Matteson Fogg, DCNP, FNP, APRN

Primary specialty

Primary Care Nurse PractitionerTaxonomy code 363LP2300X

License

APRN2794242 Issued in FL

Practice address

1019 Flora Vista St
Trinity, FL 34655-7025

Phone

(727) 698-3963

NPI assigned

Dec 14, 2014

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Dermatology Healthcare, LLC

  • Dermatology Physician
  • Tampa, FL
  • NPI 1124463104
  Medicare reassignment NPD
• Robert a. Norman, D.O., P.a.

  • Dermatology Physician
  • Tampa, FL
  • NPI 1558391219
  Medicare reassignment NPD
• Robert a. Norman, D.O., P.a.

  • Dermatology Physician
  • Riverview, FL
  • NPI 1952440711
  NPD (past)

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

{
    "created_epoch": "1418515200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1766534400000",
    "number": "1194123729",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1019 FLORA VISTA ST",
            "city": "TRINITY",
            "state": "FL",
            "postal_code": "346557025",
            "telephone_number": "727-698-3963"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1019 FLORA VISTA ST",
            "city": "TRINITY",
            "state": "FL",
            "postal_code": "346557025",
            "telephone_number": "727-698-3963"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FOGG",
        "first_name": "MARK",
        "middle_name": "MATTESON",
        "credential": "DCNP, FNP, APRN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-12-14",
        "last_updated": "2025-12-24",
        "certification_date": "2025-12-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "FL",
            "license": "APRN2794242",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Florida Medical Clinic, LLC
• Florida Pain Management Physicians PA
• Florida Woman Care ,LLC
• Florida Woman Care, LLC
• FMD Urgent Care LLC
• Ruben Gerardo Font, M.D.
• Tyler Austin Fontaine, DO
• Rudy Forte, MD
• Robin Frake, DO
• Gianni Franceschi, DDS

• Primary Care Nurse Practitioner in Trinity, FL
• Providers in Trinity, FL by specialty
• Primary Care Nurse Practitioner in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 24, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.