Active NPI
Angela Brooke Hogan, PA-C
- Physician Assistant
- Oklahoma City, OK
National Provider Identifier
1104347640
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- PA11339
- Practice address
- 1200 Childrens Ave
Oklahoma City, OK 73104-4637 - Phone
- (405) 271-4412
- NPI assigned
- Jul 6, 2017
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | PA11339 | TX | Primary |
Addresses
Primary practice location
1200 Childrens Ave
Oklahoma City, OK 73104-4637
Mailing address
1000 Houston St Ste 200
Ft Worth, TX 76102-6415
Phone (817) 336-0551
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
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2989 | OK | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1499299200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1574294400000",
"number": "1104347640",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1000 HOUSTON ST STE 200",
"city": "FT WORTH",
"state": "TX",
"postal_code": "761026415",
"telephone_number": "817-336-0551"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1200 CHILDRENS AVE",
"city": "OKLAHOMA CITY",
"state": "OK",
"postal_code": "731044637",
"telephone_number": "405-271-4412"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HOGAN",
"first_name": "ANGELA",
"middle_name": "BROOKE",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-07-06",
"last_updated": "2019-11-21",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "TX",
"license": "PA11339",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Oklahoma City, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.