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This data was extracted on 9/30/2025.

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License Number: C0005156 Kristy Michelle Fogle
License Type: Physician Assistant
License Status: Active  
License Issued: 08/22/2013  License Expiration:  06/30/2027
Licensure Pathway:  Traditional   
Special License Category:  N/A
 Medical Assistance

Accept Medicaid? N/A

Maryland Hospital Privilege Information (as reported by licensee)
Sinai Hospital Of Baltimore
Medical Licenses Held in Other States (as reported by licensee)
Licensee has not reported Medical Licenses Held in Other States information for the profile site.
 Physician Assistant Notification of Collaboration Agreements
Agreement ID: 5674 |  Submit Date: 06/26/2025
Practice Setting: Hospital
Facility: Sinai Hospital Of Baltimore
Address: 2401 West Belvedere Avenue
           Baltimore, MD 21215
Advanced Duties: No | Prescriptive Authority: Yes | Dispensing Authority: No   
View Collaboration Agreement
Agreement ID: 6256 |  Submit Date: 08/26/2025
Practice Setting: Hospital
Facility: Sinai Hospital Of Baltimore
Address: 2401 West Belvedere Avenue
           Baltimore, MD 21215
Advanced Duties: No | Prescriptive Authority: Yes | Dispensing Authority: No   
View Collaboration Agreement
Agreement ID: 6257 |  Submit Date: 08/26/2025
Practice Setting: Hospital
Facility: Northwest Hospital Center
Address: 5401 Old Court Road
           Randallstown, MD 21133
Advanced Duties: No | Prescriptive Authority: Yes | Dispensing Authority: No   
View Collaboration Agreement
Agreement ID: 6258 |  Submit Date: 08/26/2025
Practice Setting: Hospital
Facility: Carroll Hospital Center
Address: 200 Memorial Avenue
           Westminster, MD 21157
Advanced Duties: No | Prescriptive Authority: Yes | Dispensing Authority: No   
View Collaboration Agreement
Active Supervisee - Delegation Agreement For Core Duties
D0071045  Jonathan Sidney Thierman   Status: Approved  |  Approved Date:  10/21/2020  | Agreement No: 20871
Prescribe CDS: Yes  | Non-CDS: Yes  | Medical Devices: Yes
Dispense CDS: No  | Dispense NCDS: No
D0065484  Aziza Tahir Shad   Status: Approved  |  Approved Date:  07/23/2024  | Agreement No: 34607
Prescribe CDS: No  | Non-CDS: Yes  | Medical Devices: No
Dispense CDS: No  | Dispense NCDS: No
Download all Maryland Disciplinary Actions (not time-limited)
All Orders are downloaded in .pdf format.
None.
 Summary of Known Disciplinary Actions by any state medical board (within the past 10 years)   Please Read Description
In Maryland:
No Known Disciplinary Actions by the Maryland Board of Physicians have been reported.
Other States:
No Known Disciplinary Actions by any other state medical board have been reported.
 Pending Charges   Please Read Disclaimer
All Charges are downloaded in .pdf format.
None.
 Other Public Actions in the Practice of the Profession or Administrative Fines (including Maryland)   Please Read Description
No reported Other Public Actions in the Practice of the Profession or Administrative Fines (incl. Maryland) for this licensee.
 Convictions for any crime involving moral turpitude
None reported by the courts.
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