Jennifer Fogle

Primary specialty

Behavior TechnicianTaxonomy code 106S00000X

License

RBT-16-17433 Issued in SC

Practice address

2460 India Hook Rd Ste 104
Rock Hill, SC 29732-3530

Phone

(803) 366-6250

Fax

(803) 905-4431

NPI assigned

Jul 27, 2017

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Community Living in Kentucky, LLC

  • Community/Behavioral Health Agency
  • Murray, KY
  • NPI 1518281419
  NPD (past)
• Gateway Counseling Services

  • Community/Behavioral Health Agency
  • Bowling Green, KY
  • NPI 1508278458
  NPD (past)

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

{
    "created_epoch": "1501113600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1501113600000",
    "number": "1922522416",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "181 W PROFESSIONAL PARK CT STE 1",
            "city": "BOWLING GREEN",
            "state": "KY",
            "postal_code": "421043250",
            "telephone_number": "270-777-9283",
            "fax_number": "270-777-9283"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2460 INDIA HOOK RD STE 104",
            "city": "ROCK HILL",
            "state": "SC",
            "postal_code": "297323530",
            "telephone_number": "803-366-6250",
            "fax_number": "803-905-4431"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FOGLE",
        "first_name": "JENNIFER",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-07-27",
        "last_updated": "2017-07-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "SC",
            "license": "RBT-16-17433",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• John W Floren, D.M.D.
• Robin Michelle Flores
• Sandra P Flores
• Floyd Brace Company, Inc.
• Amanda Clark Floyd, MD
• Food Lion LLC
• Food Theory LLC
• Footprints South Carolina, Inc.
• For the Kids Services
• Angela Ruth Ford, COTA/L

• Behavior Technician in Rock Hill, SC
• Providers in Rock Hill, SC by specialty
• Behavior Technician in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 2017; 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.