Active NPI
Brian Kirby Fogarty, MED
- Psychologist
- Lemoyne, PA
National Provider Identifier
1285669341
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- PS004024L
- Practice address
- 426 S Third St
Ste 201
Lemoyne, PA 17043 - Phone
- (717) 737-2448
- Fax
- (717) 774-1435
- NPI assigned
- Jul 11, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | PS004024L | PA | Primary |
Addresses
Primary practice location
426 S Third St
Ste 201
Lemoyne, PA 17043
Mailing address
352 Futurity Dr
Camp Hill, PA 17011
Phone (717) 774-1218
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| F0144575 | Other | PA | HIGHMARK BLUE SHIELD |
| 01633901 | Other | PA | CAPITAL BLUE CROSS |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Master of Education
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PS004024L | PA | MD | Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1152576000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1285669341",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "352 FUTURITY DR",
"city": "CAMP HILL",
"state": "PA",
"postal_code": "17011",
"telephone_number": "717-774-1218"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "426 S THIRD ST",
"address_2": "STE 201",
"city": "LEMOYNE",
"state": "PA",
"postal_code": "17043",
"telephone_number": "717-737-2448",
"fax_number": "717-774-1435"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FOGARTY",
"first_name": "BRIAN",
"middle_name": "KIRBY",
"name_prefix": "Mr.",
"credential": "MED",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-11",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "PA",
"license": "PS004024L",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HIGHMARK BLUE SHIELD",
"identifier": "F0144575",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CAPITAL BLUE CROSS",
"identifier": "01633901",
"state": "PA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Lemoyne, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.