Active NPI
Tara Elizabeth Fogle, DC
- Rehabilitation Chiropractor
- Fairfax, VA
National Provider Identifier
1629814710
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Rehabilitation Chiropractor
- License
- S04227
- Practice address
- 3925 Chain Bridge Rd Ste 101
Fairfax, VA 22030-3938 - Phone
- (304) 830-2974
- NPI assigned
- Jul 8, 2024
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Rehabilitation Chiropractor | 111NR0400X | S04227 | MD | Primary |
Addresses
Primary practice location
3925 Chain Bridge Rd Ste 101
Fairfax, VA 22030-3938
Mailing address
9920 Fairfax SQ Apt 114
Fairfax, VA 22031-4220
Phone (304) 830-2974
Other practice location 1
4301 Garden City Dr Ste 104
Landover, MD 20785-6102
Phone (301) 577-1115
Other practice location 2
827 Rockville Pike Ste E
Rockville, MD 20852-1267
Phone (301) 251-2777
Other practice location 3
9300 Livingston Rd Ste B-100
Fort Washington, MD 20744-4908
Phone (301) 203-6734
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| S04227 | MD | MD | Rehabilitation Chiropractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1720396800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1720396800000",
"number": "1629814710",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9920 FAIRFAX SQ APT 114",
"city": "FAIRFAX",
"state": "VA",
"postal_code": "220314220",
"telephone_number": "304-830-2974"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3925 CHAIN BRIDGE RD STE 101",
"city": "FAIRFAX",
"state": "VA",
"postal_code": "220303938",
"telephone_number": "304-830-2974"
}
],
"practiceLocations": [
{
"address_1": "4301 Garden City Dr Ste 104",
"address_purpose": "LOCATION",
"city": "Landover",
"state": "MD",
"postal_code": "207856102",
"country_code": "US",
"telephone_number": "301-577-1115",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "827 Rockville Pike Ste E",
"address_purpose": "LOCATION",
"city": "Rockville",
"state": "MD",
"postal_code": "208521267",
"country_code": "US",
"telephone_number": "301-251-2777",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "9300 Livingston Rd Ste B-100",
"address_purpose": "LOCATION",
"city": "Fort Washington",
"state": "MD",
"postal_code": "207444908",
"country_code": "US",
"telephone_number": "301-203-6734",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "FOGLE",
"first_name": "TARA",
"middle_name": "ELIZABETH",
"name_prefix": "Dr.",
"credential": "DC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-07-08",
"last_updated": "2024-07-08",
"certification_date": "2024-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "111NR0400X",
"taxonomy_group": "",
"desc": "Chiropractor, Rehabilitation",
"state": "MD",
"license": "S04227",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fairfax, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.