Fogodemisa Home Care LLC

Primary specialty

In Home Supportive Care AgencyTaxonomy code 253Z00000X

Legal business name

FOGODEMISA HOME CARE LLC

Practice address

2665 John Smith Rd Ste B
Fayetteville, NC 28306-2623

Phone

(910) 476-3859

NPI assigned

Jan 18, 2022

Organization subpart

No

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

Authorized official

Name

Gold E OmogbehinNPI 1114678711

Title

Agency Director

Phone

(910) 670-1061

Specialties & licenses 1

Addresses

Other names 1

• FOGODEMISA HOME CARE LLC Former legal business name

Practitioners 1

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

• Gold Omogbehin

  • Home Health Registered Respiratory Therapist
  • Fayetteville, NC
  • NPI 1114678711
  NPD Authorized official

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

{
    "created_epoch": "1642464000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1644796800000",
    "number": "1851042295",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1308 SNOWY EGRET DR",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283063227",
            "telephone_number": "910-476-3859"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2665 JOHN SMITH RD STE B",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283062623",
            "telephone_number": "910-476-3859"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FOGODEMISA HOME CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-01-18",
        "last_updated": "2022-02-14",
        "certification_date": "2022-02-14",
        "status": "A",
        "authorized_official_last_name": "OMOGBEHIN",
        "authorized_official_first_name": "GOLD",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "AGENCY DIRECTOR",
        "authorized_official_telephone_number": "910-670-1061"
    },
    "taxonomies": [
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "FOGODEMISA HOME CARE LLC",
            "code": "4",
            "type": "Former Legal Business Name"
        },
        {
            "organization_name": "FOGODEMISA HOME CARE LLC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

• Sheila Flynn, M.ED. CCC-SLP
• Focus Vision Optometric Care, PLLC
• Lindsay Fodor
• Brittney Squires Foerster
• Charles Robert Fogle, PHARM.D.
• Deborah Lynn Foley, LPC
• Shelley Barry Follett, NP-C
• Cinthia Edwards Follrod, CPNP
• Candace Folsom
• David Henry Fonke, D.C.

• In Home Supportive Care Agency in Fayetteville, NC
• Providers in Fayetteville, NC by specialty
• In Home Supportive Care Agency in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 14, 2022; 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.