Kirk A Fougnie, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA582 Issued in KY

Practice address

4331 Churchman Ave
Suite 101
Louisville, KY 40215-1164

Phone

(502) 364-0902

Fax

(502) 364-0099

NPI assigned

Jul 18, 2005

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

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in KY

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

Specialty

Physician Assistant

Education

Other, 2000

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Live Well Orthopedic Care LLCGroup PAC ID 9739416611, 4 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

31.71 of 100Reported as individual

Quality

15

Improvement activities

0

Cost

64.74

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

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.

• Live Well Orthopedic Care LLC

  • Physician Assistant
  • Louisville, KY
  • NPI 1831754696
  Medicare reassignment Care Compare group
• Cardiac Care Center of Louisville, PLLC

  • Cardiovascular Disease Physician
  • Louisville, KY
  • NPI 1245449669
  NPD (past)
• Cogent Healthcare of Kentucky, PSC

  • Internal Medicine Physician
  • Lexington, KY
  • NPI 1053362293

  Physician Assistant

  NPD (past)
• Medical Center Cardiologists, PSC

  • Cardiovascular Disease Physician
  • Louisville, KY
  • NPI 1841288529
  NPD (past)
• Commonwealth Ear Nose & Throat-Head & Neck Center

  • Otolaryngology Physician
  • Carol Stream, IL
  • NPI 1689732836
  NPD (past)

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

{
    "created_epoch": "1121644800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1445212800000",
    "number": "1295734747",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4331 CHURCHMAN AVE",
            "address_2": "SUITE 101",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402151164",
            "telephone_number": "502-364-0902",
            "fax_number": "502-364-0099"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4331 CHURCHMAN AVE",
            "address_2": "SUITE 101",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402151164",
            "telephone_number": "502-364-0902",
            "fax_number": "502-364-0099"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FOUGNIE",
        "first_name": "KIRK",
        "middle_name": "A",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-18",
        "last_updated": "2015-10-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "KY",
            "license": "PA582",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "95001475",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PASSPORT HEALTH PLAN",
            "identifier": "50019798",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Roy Damian Foster, DMD
• Stephanie Foster
• Victoria Foster
• Will Sterrett Foster, M.D.
• Peter G Fotos, DDS
• Claudia Jane Foulkes, MS, CCC, SLP
• Foundations Family and Implant Dentistry
• Foundations Pediatric Therapy LLC
• Foundations Physical Therapy and Wellness PLLC
• Nancy Ann Fountain, RD

• Physician Assistant in Louisville, KY
• Providers in Louisville, KY by specialty
• Physician Assistant in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2015; 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.
• 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.