Individual provider Active NPI

Caroline Fogleman Mikach, CRNA

  • Certified Registered Nurse Anesthetist
  • Athens, AL
National Provider Identifier
1467969477
Registry record updated Dec 29, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
1-135557 Issued in AL
Practice address
700 W Market St
Athens, AL 35611-2457
Phone
(256) 233-9292
NPI assigned
Dec 29, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 29, 2017

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 1-135557 AL Primary

Addresses

Primary practice location

700 W Market St
Athens, AL 35611-2457

Mailing address

208 Shoals Point TRL
Madison, AL 35757-6816
Phone (205) 475-3016

Other names 1

  • Caroline Joyce Fogleman Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180327001291 AL Practitioner - Certified Registered Nurse Anesthetist (Crna) 0345502662 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Athens and Limestone County Healthcare AuthorityGroup PAC ID 3870641863, 23 clinicians

Practice addresses (Care Compare)

700 W Market St
Athens, AL 35611-2457
Phone (256) 233-9292

Hospital & facility affiliations

  • Athens Limestone Hospital Hospital, Athens, AL, CCN 010079

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Huntsville Hospital Anesthesia Nurse Anesthetist, Certified Registered CurrentSince Aug 11, 2018 Accepting new patients
Athens and Limestone County Healthcare Authority Nurse Anesthetist, Certified Registered CurrentSince Jan 21, 2018 Accepting new patients

Locations

22454 US Highway 72
Athens, AL 35613
Phone (256) 233-9292

700 W Market St
Athens, AL 35611
Phone (256) 233-9292

101 Sivley Rd SW
Huntsville, AL 35801
Phone (256) 265-9870

245 Governors Dr SE
Huntsville, AL 35801
Phone (256) 265-7673

Organizations & group practices 2

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1514505600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1514505600000",
    "number": "1467969477",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "208 SHOALS POINT TRL",
            "city": "MADISON",
            "state": "AL",
            "postal_code": "357576816",
            "telephone_number": "205-475-3016"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 W MARKET ST",
            "city": "ATHENS",
            "state": "AL",
            "postal_code": "356112457",
            "telephone_number": "256-233-9292"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIKACH",
        "first_name": "CAROLINE",
        "middle_name": "FOGLEMAN",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-12-29",
        "last_updated": "2017-12-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "AL",
            "license": "1-135557",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CAROLINE",
            "last_name": "FOGLEMAN",
            "middle_name": "JOYCE",
            "credential": "RN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Athens, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 29, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.