NPIMap

Organization Active NPI

Natalie Fogelson PLLC

  • Physical Therapist
  • Phoenix, AZ
National Provider Identifier
1487968004
Registry record updated Apr 10, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
5298 Issued in AZ
Legal business name
NATALIE FOGELSON PLLC
Practice address
4025 W Bell Rd Ste 22
Phoenix, AZ 85053-2749
Phone
(623) 580-9323
Fax
(235) 809-3186
NPI assigned
Aug 6, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 10, 2023

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

Authorized official

Name
Natalie Chantall Fogelson, PT, CLT-LANANPI 1295051985
Title
Owner/Medical Director
Phone
(623) 580-9323

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225100000X 5298 AZ Primary

Addresses

Primary practice location

4025 W Bell Rd Ste 22
Phoenix, AZ 85053-2749

Mailing address

PO Box 3635
Cottonwood, AZ 86326-2561
Phone (928) 639-0166

Other identifiers 1

IdentifierTypeStateIssuer
589960MedicaidAZ

Other names 1

  • Center for Oncological Rehabilitation and Lymphedema Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100817000757 AZ Part B Supplier - Clinic/Group Practice 6406980184 Receives reassigned benefits from 1 practitioner
Practice locations: Phoenix, AZ

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Tax ID family
Center for Oncological Rehabilitation and Lymphedema2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1281052800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1681084800000",
    "number": "1487968004",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3635",
            "city": "COTTONWOOD",
            "state": "AZ",
            "postal_code": "863262561",
            "telephone_number": "928-639-0166",
            "fax_number": "928-639-0167"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4025 W BELL RD STE 22",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850532749",
            "telephone_number": "623-580-9323",
            "fax_number": "235-809-3186"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NATALIE FOGELSON PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-08-06",
        "last_updated": "2023-04-10",
        "certification_date": "2023-04-10",
        "status": "A",
        "authorized_official_last_name": "FOGELSON",
        "authorized_official_first_name": "NATALIE",
        "authorized_official_middle_name": "CHANTALL",
        "authorized_official_title_or_position": "OWNER/MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "623-580-9323",
        "authorized_official_credential": "PT, CLT-LANA"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": "AZ",
            "license": "5298",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "589960",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Center for Oncological Rehabilitation and Lymphedema",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Center for Oncological Rehabilitation and Lymphedema",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Phoenix, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.