Shanine Theres Fogle

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

OT13740 Issued in FL

Practice address

8477 S Suncoast Blvd
Homosassa, FL 34446-5028

Phone

(352) 382-7214

Fax

(352) 382-7781

NPI assigned

Jul 27, 2021

Sex

Female

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

Enrollment records 1

Specialty

Occupational Therapist in Private Practice

Education

Other, 2009

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Empowerme Rehabilitation Florida, LLCGroup PAC ID 3274962790, 151 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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.

• Empowerme Rehabilitation Florida, LLC

  • Multi-Specialty Clinic/Center
  • Stuart, FL
  • NPI 1184257602
  Care Compare group NPD
• Empowerme Rehabilitation Florida, LLC

  • Rehabilitation Clinic/Center
  • The Villages, FL
  • NPI 1477245892
  NPD

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

{
    "created_epoch": "1627344000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1627344000000",
    "number": "1265105175",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8477 S SUNCOAST BLVD",
            "city": "HOMOSASSA",
            "state": "FL",
            "postal_code": "344465028",
            "telephone_number": "352-382-7214",
            "fax_number": "352-382-7781"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8477 S SUNCOAST BLVD",
            "city": "HOMOSASSA",
            "state": "FL",
            "postal_code": "344465028",
            "telephone_number": "352-382-7214",
            "fax_number": "352-382-7781"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FOGLE",
        "first_name": "SHANINE",
        "middle_name": "THERES",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-07-27",
        "last_updated": "2021-07-27",
        "certification_date": "2021-07-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "FL",
            "license": "OT13740",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Donna Degraff Fisher, RN
• Taryn Jayne Flagg, OT
• Rhaea Flavin, OT/R
• Constance D Flores, PA
• Florida Family Health Medical Center PLLC
• Scott Fontechia III
• Frank J Vascimini DDS PA
• Trevon Franklin
• Ayanna Frederick
• Angela W Freeman, SA10283

• Occupational Therapist in Homosassa, FL
• Providers in Homosassa, FL by specialty
• Occupational Therapist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.