Eagles Nest Group Home

Primary specialty

Respite CareTaxonomy code 385H00000X

Legal business name

EAGLES NEST GROUP HOME

Practice address

4310 Toro CT
Reno, NV 89502-6426

Phone

(775) 852-1078

NPI assigned

Mar 30, 2016

Organization subpart

No

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

Authorized official

Name

Theresa FogalNPI 1144776170

Title

Provider

Phone

(775) 852-1078

Specialties & licenses 1

Addresses

Other identifiers 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Theresa Fogal

  • Respite Care
  • Reno, NV
  • NPI 1144776170
  NPD (past) Authorized official

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

{
    "created_epoch": "1459296000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1459296000000",
    "number": "1821451675",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4310 TORO CT",
            "city": "RENO",
            "state": "NV",
            "postal_code": "895026426",
            "telephone_number": "775-852-1078"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4310 TORO CT",
            "city": "RENO",
            "state": "NV",
            "postal_code": "895026426",
            "telephone_number": "775-852-1078"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EAGLES NEST GROUP HOME",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-03-30",
        "last_updated": "2016-03-30",
        "status": "A",
        "authorized_official_last_name": "FOGAL",
        "authorized_official_first_name": "THERESA",
        "authorized_official_title_or_position": "PROVIDER",
        "authorized_official_telephone_number": "775-852-1078"
    },
    "taxonomies": [
        {
            "code": "385H00000X",
            "taxonomy_group": "",
            "desc": "Respite Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9005053465",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Laura Dykins, APRN
• Samuel Thomas Dykstra
• Dynamic Movement Physical Therapy Inc
• Noor A Dythavon, RN, MSN, NP
• E. a. Angelini OD LTD
• David Ealy, PMHNP
• Kevin B Earl
• Teri Earl
• Earle Oki MD Prof Corp
• Janette Rae Early, M.F.T.

• Respite Care in Reno, NV
• Providers in Reno, NV by specialty
• Respite Care in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 2016; 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.