Luke Burkett Fondren, DO

Primary specialty

Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X

Practice address

1613 N McKenzie St
Foley, AL 36535-2247

Phone

(251) 949-3400

NPI assigned

Apr 3, 2018

Last updated

Apr 2, 2020By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in AL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/4349/brand/1/csg/1/fhir/r4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• BHG Lxxii, LLC

  dba BHG Medical Services - Mobile

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Mobile, AL
  • NPI 1699440149
  Medicare reassignment NPD
• Eastern Shore Urgent Care LLC

  • Family Medicine Physician
  • Daphne, AL
  • NPI 1376706275
  Medicare reassignment NPD
• Eastern Shore Urgent Care LLC

  • Urgent Care Clinic/Center
  • Chestertown, MD
  • NPI 1548924988
  NPD (past)

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

{
    "created_epoch": "1522713600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1585785600000",
    "number": "1255837886",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7856 WESTSIDE PARK DR STE H",
            "city": "MOBILE",
            "state": "AL",
            "postal_code": "366958539",
            "telephone_number": "251-450-8151"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1613 N MCKENZIE ST",
            "city": "FOLEY",
            "state": "AL",
            "postal_code": "365352247",
            "telephone_number": "251-949-3400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FONDREN",
        "first_name": "LUKE",
        "middle_name": "BURKETT",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-04-03",
        "last_updated": "2020-04-02",
        "certification_date": "2020-04-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "AL",
            "license": "DO.2036",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "AL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Foley Therapy LLC
• Foley Therapy LLC
• Foley Therapy LLC
• Foley Urgent Care LLC
• Foley Walk-in Med Care
• Shelley Young Fontaine
• Laura Ford, CRNP
• Marilyn Courtney Forehand, CRNP
• Katarina Forsthoefel
• Christopher Jerome Frailie, MD

• Student in an Organized Health Care Education/Training Program in Foley, AL
• Providers in Foley, AL by specialty
• Student in an Organized Health Care Education/Training Program in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 2020; 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.