Kimberly Fogle, CCC

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

111521 Issued in TX

Practice address

2115 Raintree Dr
Carrollton, TX 75006-4719

Phone

(972) 968-1425

Fax

(972) 968-1410

NPI assigned

Sep 10, 2021

Sex

Female

Sole proprietor

Yes

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1631232000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1631232000000",
    "number": "1558030775",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2115 RAINTREE DR",
            "city": "CARROLLTON",
            "state": "TX",
            "postal_code": "750064719",
            "telephone_number": "972-968-1425",
            "fax_number": "972-968-1410"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2115 RAINTREE DR",
            "city": "CARROLLTON",
            "state": "TX",
            "postal_code": "750064719",
            "telephone_number": "972-968-1425",
            "fax_number": "972-968-1410"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FOGLE",
        "first_name": "KIMBERLY",
        "credential": "CCC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-09-10",
        "last_updated": "2021-09-10",
        "certification_date": "2021-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Speech-Language Pathologist",
            "state": "TX",
            "license": "111521",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Laura Fletcher
• Esther Sarai Flores, LICENSE SLP
• Laura Flores, D.C.
• Jeffrey Lynn Flower, D.D.S.
• Amber Fluker
• Christine Foley, D.D.S., M.S.
• Jamie Foo, COTA/L
• Footcare PA
• Pamela V. Ford, D.C.
• Lisa Marie Fore, OTR, CEAS

• Speech-Language Pathologist in Carrollton, TX
• Providers in Carrollton, TX by specialty
• Speech-Language Pathologist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.