Active NPI
Heather Jean Fogelman, PT
- Physical Therapist
- Woodbine, IA
National Provider Identifier
1366869356
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 03799
- Practice address
- 518 Lincolnway St
Woodbine, IA 51579-1238 - Phone
- (712) 647-2566
- Fax
- (712) 647-2964
- NPI assigned
- Mar 27, 2014
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 03799 | IA | Primary |
Addresses
Primary practice location
518 Lincolnway St
Woodbine, IA 51579-1238
Mailing address
631 N 8TH St
Missouri Valley, IA 51555-1102
Phone (712) 642-2179
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 03799 | IA | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Alegent Creighton Clinic | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Family Medicine Physician
- Council Bluffs, IA
- NPI 1598811069
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1395878400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1395878400000",
"number": "1366869356",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "631 N 8TH ST",
"city": "MISSOURI VALLEY",
"state": "IA",
"postal_code": "515551102",
"telephone_number": "712-642-2179",
"fax_number": "712-642-3510"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "518 LINCOLNWAY ST",
"city": "WOODBINE",
"state": "IA",
"postal_code": "515791238",
"telephone_number": "712-647-2566",
"fax_number": "712-647-2964"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FOGELMAN",
"first_name": "HEATHER",
"middle_name": "JEAN",
"credential": "PT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2014-03-27",
"last_updated": "2014-03-27",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "IA",
"license": "03799",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Woodbine, IA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.