Rebecca J Hafner-Fogarty, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

25004 Issued in MN

Practice address

33491 135TH Ave
Avon, MN 56310-9617

Phone

(320) 356-1019

NPI assigned

Jun 30, 2006

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 MN

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

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.

• Centracare Health System - Long Prairie

  • Critical Access Hospital
  • Long Prairie, MN
  • NPI 1164471678
  Medicare reassignment
• Affiliated Community Medical Centers, LTD

  • Multi-Specialty Clinic/Center
  • Willmar, MN
  • NPI 1952363699
  NPD (past)

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

{
    "created_epoch": "1151625600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1497783963",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "33491 135TH AVE",
            "city": "AVON",
            "state": "MN",
            "postal_code": "563109617",
            "telephone_number": "320-356-1019"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "33491 135TH AVE",
            "city": "AVON",
            "state": "MN",
            "postal_code": "563109617",
            "telephone_number": "320-356-1019"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAFNER-FOGARTY",
        "first_name": "REBECCA",
        "middle_name": "J",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-30",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MN",
            "license": "25004",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Avon Dental PLLC
• Kathleen Alice Beuning, CNP
• Preston Bryant
• Central Minnesota Alarms, Inc,
• Alyssa Lynn Gullickson, D.D.S.
• Hannah Hicks, LCSW, LICSW
• Mark Janorschke, CRNA
• Alex Lange
• Minnesota Orthotics
• Kathleen M Moen, DDS

• Family Medicine Physician in Avon, MN
• Providers in Avon, MN by specialty
• Family Medicine Physician in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.