Shelley Fogt

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

APRN.CNP.18696 Issued in OH

Practice address

602 W Redskin TRL
Wapakoneta, OH 45895-9349

Phone

(419) 738-5151

NPI assigned

Apr 13, 2016

Last updated

Feb 27, 2025By 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

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in OH

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Lima Memorial Professional CorporationGroup PAC ID 1254232184, 167 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Lima Memorial Health System Hospital, Lima, OH, CCN 360009
• Mercy Health St Ritas Medical Center Hospital, Lima, OH, CCN 360066

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Nurse Practitioner, Nurse Practitioner

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: shelley.fogt@lmpc.eclinicaldirectplus.com

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.

• Lima Memorial Professional Corporation

  • Specialist
  • Lima, OH
  • NPI 1457474900
  Medicare reassignment Care Compare group NPD
• Lima Memorial Joint Operating Company

  dba Lima Memorial Health System

  • General Acute Care Hospital
  • Lima, OH
  • NPI 1336144732
  NPD (past)
• Lima Memorial Professional Corporation

  dba Lima Group Family Physicians

  • Family Medicine Physician
  • Lima, OH
  • NPI 1114978244
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Lima Memorial Joint Operating Company

  dba Lima Memorial Health System

  • General Acute Care Hospital
  • Lima, OH
  • NPI 1336144732
  Care Compare affiliation
• Mercy Health-St Ritas Medical Center LLC

  dba Inpatient Psych Unit

  • Psychiatric Hospital Unit
  • Lima, OH
  • NPI 1447276936
  Care Compare affiliation
• Mercy Health-St Ritas Medical Center LLC

  dba Mercy Health-St Rita's Medical Center

  • General Acute Care Hospital
  • Lima, OH
  • NPI 1811939887
  Care Compare affiliation

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

{
    "created_epoch": "1460505600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740614400000",
    "number": "1861856015",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1001 BELLEFONTAINE AVE",
            "city": "LIMA",
            "state": "OH",
            "postal_code": "458042800",
            "telephone_number": "419-998-4575",
            "fax_number": "419-998-4586"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "602 W REDSKIN TRL",
            "city": "WAPAKONETA",
            "state": "OH",
            "postal_code": "458959349",
            "telephone_number": "419-738-5151"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FOGT",
        "first_name": "SHELLEY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-04-13",
        "last_updated": "2025-02-27",
        "certification_date": "2025-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OH",
            "license": "APRN.CNP.18696",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0205648",
            "state": "OH"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "shelley.fogt@lmpc.eclinicaldirectplu.com",
            "affiliation": "N",
            "endpointDescription": "Direct Messaging Address",
            "address_1": "602 W Redskin Trl",
            "city": "Wapakoneta",
            "state": "OH",
            "country_code": "US",
            "postal_code": "458959349",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Michelle L Evans, SWA
• Everside Health, LLC
• Kelli L Eyink, LPT
• Stephen Scott Fleck, OD
• Melissa Ann Fogt, APRN-CNP
• Sierra Dawn Foor
• Heidi Lee Fuller
• Gardens a Wapakoneta Operating Company LLC (The Gardens at Wapakoneta)
• Cathleen Irene Garman, R.PH
• Polly Ann Garmatter, LPN

• Family Nurse Practitioner in Wapakoneta, OH
• Providers in Wapakoneta, OH by specialty
• Family Nurse Practitioner in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.