CHARLES M FOFANG (NPI# 1093225989) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1093225989 |
| Entity Type | Individual |
| Full Name | CHARLES M FOFANG |
| Credential | NP |
| Practice Address |
1812 Brittany Ln Edmond OK 73003-3810 |
| Practice Telephone | 2162699592 |
| Mailing Telephone | 2162699592 |
| Enumeration Date | 2017-10-04 |
| Last Update Date | 2017-10-04 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363L00000X | Nurse Practitioner | F10170079 | OK | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
1812 BRITTANY LN |
| City | EDMOND |
| State | OK |
| Zip Code | 73003-3810 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154945202 | Korbin Hally | Dentist | 2600 Tayler Street, Edmond, OK 73003 | 2020-06-04 |
| 1003448325 | Diagnostic Resources, LLC | Physical Medicine & Rehabilitation | 1641 Saratoga Way, Edmond, OK 73003 | 2020-02-05 |
| 1861904021 | Rhonda Diane Pennington | Occupational Therapist | 515 S Santa Fe Ave Ste 103, Edmond, OK 73003 | 2017-10-27 |
| 1588173744 | Hpc Holdings LLC | Clinic/Center | 813 W Covell Rd, Edmond, OK 73003 | 2017-09-20 |
| 1194243568 | Nightengale Chiropractic, LLC | Chiropractor | 2616 Covell Village Dr Ste. 120, Edmond, OK 73003 | 2017-09-06 |
| 1104274927 | Bonsu Osei Asibey | Case Manager/Care Coordinator | 1301 Craig Blvd, Edmond, OK 73003 | 2016-06-02 |
| 1215390810 | Prince Yebo | Case Manager/Care Coordinator | 1817 Redland Dr, Edmond, OK 73003 | 2016-03-31 |
| 1548621691 | Charles Loftis | Physical Therapist | 1321 Fretz Drive, 100, Edmond, OK 73003 | 2016-03-17 |
| 1487013801 | Courage Counseling Center | Community/Behavioral Health | 1400 S. Fretz Ave, Suite 1400, Edmond, OK 73003 | 2016-02-12 |
| 1669889887 | Shannon Gogel | Occupational Therapy Assistant | 1309 Val Genes Rd, Edmond, OK 73003 | 2014-07-21 |
| Find all providers in zip 73003 | ||||
| Taxonomy Code | 363L00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| (1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners. |
| Notes: Source: (1) American Nurses’ Association, American Nurses Credentialing Center, 1996 Certification Catalogue. (2) ) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, The Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, Illinois: 1994, p. 549. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093322240 | Lacey Campbell | Nurse Practitioner | 6124 Beverly Hills Dr, Edmond, OK 73034-8690 | 2020-09-30 |
| 1760017321 | Jennyfer Lynn Livingston | Nurse Practitioner | 105 S Bryant Ave # 205, Edmond, OK 73034-6399 | 2020-03-04 |
| 1770123655 | Jennifer Katherine Yeaman | Nurse Practitioner | 4905 Nw 155th St, Edmond, OK 73013-9666 | 2020-01-08 |
| 1922505593 | Heather Hollingsworth Hallmark | Nurse Practitioner | 544 Nw 172nd Pl, Edmond, OK 73012-6778 | 2018-04-10 |
| 1740792431 | Michelle R Lacy | Nurse Practitioner | 6600 Blackberry Rd, Edmond, OK 73034-9421 | 2017-11-02 |
| 1285171413 | James Lewis Constanzer | Nurse Practitioner | 14562 S Western Ave, Edmond, OK 73025-1645 | 2017-01-26 |
| 1982630778 | Carrie A Schmidt Konen | Nurse Practitioner | 3217 Hunter Crest Dr, Edmond, OK 73034-0002 | 2006-06-23 |
| 1871554808 | Kim B. Knox | Nurse Practitioner | 19409 N Portland Ave, Edmond, OK 73012-9117 | 2006-03-29 |
| 1588655070 | Monica Esparza | Nurse Practitioner | 1 S Bryant Ave, Edmond, OK 73034-6309 | 2005-11-02 |
| 1215928700 | Tina Ledet | Nurse Practitioner | One South Bryant, Edmond, OK 73034 | 2005-11-02 |
| Find all providers in EDMOND | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.