Lori Ann Fagan

Primary specialty

Registered DietitianTaxonomy code 133V00000X

License

486 Issued in WV

Practice address

10475 Banyan Breeze Blvd
Land O Lakes, FL 34638-5720

Phone

(304) 598-1560

Fax

(304) 322-0601

NPI assigned

Feb 1, 2007

Sex

Female

Sole proprietor

No

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

Enrolled in WV, FL2 enrollments

Enrollment records 2

Specialty

Registered Dietitian Or Nutrition Professional

Education

Other, 1997

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

The Dietitians Group of West Florida, IncGroup PAC ID 0749417046, 6 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• The Dietitians Group of West Florida, Inc.

  • Registered Dietitian
  • Palm Harbor, FL
  • NPI 1295161040

  Dietitian, Registered

  Medicare reassignment Care Compare group NPD
• Morgantown Physical Therapy Associates, Inc.

  • Physical Therapist
  • Morgantown, WV
  • NPI 1437191756
  Medicare reassignment NPD
• Morgantown Physical Therapy Associates, Inc.

  • Durable Medical Equipment & Medical Supplies
  • Morgantown, WV
  • NPI 1922486026
  NPD

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

{
    "created_epoch": "1170288000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1767657600000",
    "number": "1659418093",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10475 BANYAN BREEZE BLVD",
            "city": "LAND O LAKES",
            "state": "FL",
            "postal_code": "346385720",
            "telephone_number": "304-598-1560",
            "fax_number": "304-322-0601"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10475 BANYAN BREEZE BLVD",
            "city": "LAND O LAKES",
            "state": "FL",
            "postal_code": "346385720",
            "telephone_number": "304-598-1560",
            "fax_number": "304-322-0601"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAGAN",
        "first_name": "LORI",
        "middle_name": "ANN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-01",
        "last_updated": "2026-01-06",
        "certification_date": "2026-01-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "WV",
            "license": "486",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Aleaha Evans
• Shelly Lynn Evans, D.C.
• Excellence in Home Health Services LLC
• Eye Works of Land O' Lakes
• Sharie M Fabregas, PSY.D
• Nino Anthony Fajardo, AGACNP-BC
• Family Dental at Connerton
• Michael Oneal Farrow II
• Samar Fathalla
• Reema Joseph Felix, PMHNP-BC

• Registered Dietitian in Land O Lakes, FL
• Providers in Land O Lakes, FL by specialty
• Registered Dietitian in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.