Individual provider Active NPI

Mary P Hogan, MD

  • Gynecology Physician
  • Prescott, AZ
National Provider Identifier
1023010964
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gynecology PhysicianTaxonomy code 207VG0400X
License
53387 Issued in AZ
Practice address
1005 Division St
Prescott, AZ 86301-1601
Phone
(928) 776-8428
Fax
(928) 776-8057
NPI assigned
Aug 11, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gynecology Physician 207VG0400X 53387 AZ Primary

Addresses

Primary practice location

1005 Division St
Prescott, AZ 86301-1601

Mailing address

1005 Division Street
Prescott, AZ 86301
Phone (928) 776-8428

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Genesis OB GYN PLLC CurrentSince Dec 1, 2024 Accepting new patients
DRS.Esposito,Mayer, Hogan & Assic Past Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

1005 Division St
Prescott, AZ 86301
Phone (520) 776-8428

3262 N Windsong Dr
Ste B
Prescott Valley, AZ 86314
Phone (928) 708-4545

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/19050/brand/1/csg/1/fhir/r4

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1123718400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1023010964",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1005 DIVISION STREET",
            "city": "PRESCOTT",
            "state": "AZ",
            "postal_code": "86301",
            "telephone_number": "928-776-8428",
            "fax_number": "928-776-8057"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1005 DIVISION ST",
            "city": "PRESCOTT",
            "state": "AZ",
            "postal_code": "863011601",
            "telephone_number": "928-776-8428",
            "fax_number": "928-776-8057"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOGAN",
        "first_name": "MARY",
        "middle_name": "P",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-08-11",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207VG0400X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Gynecology",
            "state": "AZ",
            "license": "53387",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Prescott, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 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.