Laurel Kate Defoggi, FNP-BC

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

79174 Issued in ID

Practice address

951 E Plaza Dr Ste 110
Eagle, ID 83616-6567

Phone

(208) 274-9580

NPI assigned

Apr 16, 2024

Last updated

Apr 16, 2024By the provider in NPPES

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 ID

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

Nurse Practitioner

Education

Other, 2024

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Woundpro TechnologiesGroup PAC ID 9032551106, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Woundpro Technologies

  • Family Medicine Physician
  • Meridian, ID
  • NPI 1649055120
  Medicare reassignment Care Compare group NPD
• Pine Valley Health LLC

  • Rheumatology Physician
  • Boise, ID
  • NPI 1942098074
  Medicare reassignment NPD
• Treasure Valley Metabolic Medicine

  • Endocrinology, Diabetes & Metabolism Physician
  • Eagle, ID
  • NPI 1285271635
  Medicare reassignment NPD

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

{
    "created_epoch": "1713225600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713225600000",
    "number": "1356195200",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "951 E PLAZA DR STE 110",
            "city": "EAGLE",
            "state": "ID",
            "postal_code": "836166567",
            "telephone_number": "208-274-9580"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "951 E PLAZA DR STE 110",
            "city": "EAGLE",
            "state": "ID",
            "postal_code": "836166567",
            "telephone_number": "208-274-9580"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEFOGGI",
        "first_name": "LAUREL",
        "middle_name": "KATE",
        "name_prefix": "Ms.",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-04-16",
        "last_updated": "2024-04-16",
        "certification_date": "2024-04-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "ID",
            "license": "79174",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cameron Daron
• Natasha Davey
• Edward D Davila, MD
• Greg Ron Davis, D.D.S
• Dawn Soriano PLLC (Dawn Soriano LCSW)
• Christopher Deja
• Alison R Dekerchove, PA-C
• Adele R Dela Roaa, LMT
• Samantha Jane Dembski, M.S.,CCC-SLP
• Marie Demers, MA, LPC

• Family Nurse Practitioner in Eagle, ID
• Providers in Eagle, ID by specialty
• Family Nurse Practitioner in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 2024; 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.