Sharon Kay Goodwin Fogleman, MD
Individual provider Active NPI Family Medicine Physician · Beverly, KY
NPI 1609862952 · NPPES record last updated Feb 28, 2011
Key facts
- NPI
- 1609862952
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- 33565 (KY)
- Practice address
- 53 Queendale Ctr
Red Bird Clinic
Beverly, KY 40913-9608 - Phone
- (606) 598-5135
- Fax
- (606) 598-8942
- NPI assigned
- Sep 22, 2005
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Red Bird Clinic, Inc. | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 33565 | KY | Yes |
Addresses
Primary practice location
53 Queendale Ctr
Red Bird Clinic
Beverly, KY 40913-9608
Mailing address
53 Queendale Ctr
Red Bird Clinic
Beverly, KY 40913-9608
Phone (606) 598-5135
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 64056377 | Medicaid | KY |
Other providers in Beverly, KY
- Millard Lynn Fogleman
- Aaron N. Frye
- Memorial Hospital Inc
- Memorial Hospital, Inc.
- Bruce D. Polly
- Red Bird Clinic, Inc.
All providers in Beverly, KY · Family Medicine Physician in Kentucky
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 28, 2011. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.