Heather M Fago, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

TEP5093 Issued in NE

Practice address

2114 N Lincoln Ave
Suite a
York, NE 68467-1072

Phone

(402) 362-5555

Fax

(402) 362-7137

NPI assigned

Jul 31, 2006

Last updated

Jan 24, 2011By the provider in NPPES

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

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NE

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

• Tabitha, Inc.

  dba Tabitha Hospice

  • Community Based Hospice Care Agency
  • Lincoln, NE
  • NPI 1275618753

  Contracted Managing Employee

  CMS ownership

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Tabitha, Inc.

  dba Tabitha Hospice

  • Community Based Hospice Care Agency
  • Lincoln, NE
  • NPI 1275618753

  Family Medicine

  NPD (past)

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

{
    "created_epoch": "1154304000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1295827200000",
    "number": "1689680605",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2114 N LINCOLN AVE",
            "address_2": "SUITE A",
            "city": "YORK",
            "state": "NE",
            "postal_code": "684671072",
            "telephone_number": "402-362-5555",
            "fax_number": "402-362-7137"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2114 N LINCOLN AVE",
            "address_2": "SUITE A",
            "city": "YORK",
            "state": "NE",
            "postal_code": "684671072",
            "telephone_number": "402-362-5555",
            "fax_number": "402-362-7137"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAGO",
        "first_name": "HEATHER",
        "middle_name": "M",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-31",
        "last_updated": "2011-01-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NE",
            "license": "TEP5093",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "47055301100",
            "state": "NE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Randy Lee Ervin, PSYD
• Joseph C. Erwin, M.D.
• Victoria Escalera
• Melissa Ewing, MS,ATC,LAT
• Eyecare Associates
• Todd M Fago, MD
• Family First Counseling
• Kate Fehlhafer, MS, CFY-SLP
• Brady Allen Fickenscher, M.D.
• Stevie Fisher

• Family Medicine Physician in York, NE
• Providers in York, NE by specialty
• Family Medicine Physician in Nebraska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.