Active NPI
Kathleen S Fogle, CCC-SLP
- Speech-Language Pathologist
- Marlton, NJ
National Provider Identifier
1639733769
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 41YS00794300
- Practice address
- 751 Route 73 N
Marlton, NJ 08053-3463 - Phone
- (856) 375-2914
- NPI assigned
- Apr 24, 2019
- 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 |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 41YS00794300 | NJ | Primary |
Addresses
Primary practice location
751 Route 73 N
Marlton, NJ 08053-3463
Mailing address
116 Burgundy CT
Wenonah, NJ 08090-2032
Phone (856) 693-1325
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 14110145 | Other | NJ | ASHA CERTIFICAT OF CLINICAL COMPETENCE |
| 41YS00794300 | Other | NJ | STATE OF NEW JERSEY DIVISION OF CONSUMER AFFAIRS |
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 |
|---|---|---|---|
| 41YS00794300 | NJ | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1556064000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1556064000000",
"number": "1639733769",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "116 BURGUNDY CT",
"city": "WENONAH",
"state": "NJ",
"postal_code": "080902032",
"telephone_number": "856-693-1325"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "751 ROUTE 73 N",
"city": "MARLTON",
"state": "NJ",
"postal_code": "080533463",
"telephone_number": "856-375-2914"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FOGLE",
"first_name": "KATHLEEN",
"middle_name": "S",
"name_prefix": "Miss",
"credential": "CCC-SLP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-04-24",
"last_updated": "2019-04-24",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "NJ",
"license": "41YS00794300",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ASHA CERTIFICAT OF CLINICAL COMPETENCE",
"identifier": "14110145",
"state": "NJ"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "STATE OF NEW JERSEY DIVISION OF CONSUMER AFFAIRS",
"identifier": "41YS00794300",
"state": "NJ"
}
],
"endpoints": [],
"other_names": []
}Other providers in Marlton, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.