Connie J Fogle, FNP-BC
Individual provider Active NPI Family Nurse Practitioner · Brentwood, TN
NPI 1467894584 · NPPES record last updated Nov 7, 2023
Key facts
- NPI
- 1467894584
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- 24223 (TN)
- Practice address
- 750 Old Hickory Blvd Ste 1-262a
Brentwood, TN 37027-4528 - Phone
- (615) 994-8416
- Fax
- (855) 919-6233
- NPI assigned
- Jul 18, 2013
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 3
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in TN
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20190305002637 | TN | Practitioner - Nurse Practitioner | 7113248444 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 24223 | TN | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Abode Care Partners, P.C. | Current |
Accepting new patients | |
| Abode Care Partners Al VB, LLC | Current |
Accepting new patients | |
| Abode Care Partners Al VB, LLC | Current |
Accepting new patients |
Locations
805 N Whittington Pkwy
Ste 400
Louisville, KY 40222
Phone (502) 272-3438
26110 Emery Rd
Ste 300
Warrensvl Hts, OH 44128
Phone (216) 292-5750
919 Medical Park Dr
Mountain City, TN 37683
Phone (423) 727-7800
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 24223 | TN | Yes |
Addresses
Primary practice location
750 Old Hickory Blvd Ste 1-262a
Brentwood, TN 37027-4528
Mailing address
26110 Emery Rd Ste 300
Warrensville Heights, OH 44128-5788
Phone (440) 368-6868
Other providers in Brentwood, TN
- Florida Ionm Services, LLC
- Janine Flowers
- Phylliss Lamora Flowers
- Marguerite Anne Flynn
- Revoydia Tamayshia Ann Flynn
- Laurel Fohn
- Foley Clinic Corp
- Brandon Micah Foltz
- Bridget Fomby
- Eugene G Fong
All providers in Brentwood, TN · Family Nurse Practitioner in Tennessee
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 7, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.