Nicole Theiss Fogwell, PHD

Primary specialty

Health PsychologistTaxonomy code 103TH0004X

Practice address

1695 NW 9TH Ave Ste 2416
Miami, FL 33136-1409

Phone

(440) 212-2384

NPI assigned

May 8, 2025

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

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Psychologist

Education

Other, 2024

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Sailor Health Medical PAGroup PAC ID 4486182342, 301 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

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.

• Sailor Health Medical PA

  • Psychologist
  • Coral Gables, FL
  • NPI 1841012960
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1746662400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1746662400000",
    "number": "1396535894",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "960 SW 2ND ST APT 3",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331301137",
            "telephone_number": "440-212-2384"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1695 NW 9TH AVE STE 2416",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331361409",
            "telephone_number": "440-212-2384"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FOGWELL",
        "first_name": "NICOLE",
        "middle_name": "THEISS",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-05-08",
        "last_updated": "2025-05-08",
        "certification_date": "2025-05-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TH0004X",
            "taxonomy_group": "",
            "desc": "Psychologist, Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• FMSC Summerville Hallmark Operating Company LLC
• FMSC Summerville Oakbrook Operating Company LLC
• FMSC Thomasville Operating Company LLC
• Focus in Care Training & Consulting, Inc
• Eugene Foerster III, LCSW
• Mark J Foley, M.D
• Paul Edward Foley, LMT
• Laura Folgueira Jova, DDS
• Folklore Pharmacy Discount Inc
• Susan E Folstein, M.D.

• Health Psychologist in Miami, FL
• Providers in Miami, FL by specialty
• Health Psychologist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 8, 2025; 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.