Clarence E. Fogleman III, M.D.

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

License

27918 Issued in CO

Practice address

111 E Polk St
Colorado Springs, CO 80907-6267

Phone

(719) 473-8801

Fax

(719) 473-8581

NPI assigned

Jul 18, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

• Claflin Eye Care, PLLC

  • Optometrist
  • Canon City, CO
  • NPI 1154600195
  NPD (past)
• Oneopto Co 1 PLLC

  • Optometrist
  • Canon City, CO
  • NPI 1235089178
  NPD (past)

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

{
    "created_epoch": "1153180800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1344556800000",
    "number": "1629096243",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 E POLK ST",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809076267",
            "telephone_number": "719-473-8801",
            "fax_number": "719-473-8581"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 E POLK ST",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809076267",
            "telephone_number": "719-473-8801",
            "fax_number": "719-473-8581"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FOGLEMAN",
        "first_name": "CLARENCE",
        "middle_name": "E.",
        "name_suffix": "III",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-18",
        "last_updated": "2012-08-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "CO",
            "license": "27918",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1279181",
            "state": "CO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "020006928",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "FO30141",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Daniel Paul Fogarty, MPT
• Taylor Marie Fogarty, DPT
• Todd M Fogarty, DDS
• Christina Fogel
• Tracey L Fogle
• Marymar Folbrecht
• Brittany Foldes
• C. Michelle Foley
• Ceile Foley
• Erin Eileen Foley

• Ophthalmology Physician in Colorado Springs, CO
• Providers in Colorado Springs, CO by specialty
• Ophthalmology Physician in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 2012; 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.