Individual provider Active NPI

Marjorie A. Vogt, CNP

  • Nurse Practitioner
  • Sunbury, OH
National Provider Identifier
1114968344
Registry record updated Apr 26, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
COA.03795.NA Issued in OH
Practice address
100 Tippett CT
Suite 101
Sunbury, OH 43015-1047
Phone
(740) 965-3123
Fax
(740) 965-9713
NPI assigned
Jun 9, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 26, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X COA03795NP OH
Nurse Practitioner 363L00000X COA.03795.NA OH Primary

Addresses

Primary practice location

100 Tippett CT
Suite 101
Sunbury, OH 43015-1047

Mailing address

575 Copelan Mill BD Suite 1D
Westerville, OH 43081
Phone (740) 615-1324

Other identifiers 4

IdentifierTypeStateIssuer
500009946OtherTRAVELERS MEDICARE
2150774MedicaidOH
353077OtherSUBMITTER NO.
NP04703OtherPALMETTO MEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050406000919 OH Practitioner - Nurse Practitioner 4082661566 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Practitioner, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
COA.03795.NAOHMDNurse Practitioner
COA03795NPOHMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Mount Carmel Health System CurrentSince Dec 11, 2016 Accepting new patients
Wedgewood Urgent Care, LTD CurrentSince Dec 11, 2016 Accepting new patients
Pro-Active Wound Care Clinics LLC PastSince Dec 11, 2016 Accepting new patients
Immediate Health Associates Past Accepting new patients
Healthworks, LLC Past Accepting new patients

Locations

4460 Lake Forest Dr
Ste 216
Blue Ash, OH 45242
Phone (614) 234-0600

10330 Sawmill Pkwy
Ste 300
Powell, OH 43065
Phone (614) 234-0600

444 N Cleveland Ave
Ste 130
Westerville, OH 43082
Phone (614) 839-1112

477 Cooper Rd
Ste 300
Westerville, OH 43081
Phone (614) 898-8808

500 S Cleveland Ave
Westerville, OH 43081
Phone (380) 898-4000

Organizations & group practices 5

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": "1149811200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1461628800000",
    "number": "1114968344",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "575 COPELAN MILL BD SUITE 1D",
            "city": "WESTERVILLE",
            "state": "OH",
            "postal_code": "43081",
            "telephone_number": "740-615-1324",
            "fax_number": "740-615-1344"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 TIPPETT CT",
            "address_2": "SUITE 101",
            "city": "SUNBURY",
            "state": "OH",
            "postal_code": "430151047",
            "telephone_number": "740-965-3123",
            "fax_number": "740-965-9713"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VOGT",
        "first_name": "MARJORIE",
        "middle_name": "A.",
        "credential": "CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-09",
        "last_updated": "2016-04-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "OH",
            "license": "COA03795NP",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "OH",
            "license": "COA.03795.NA",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRAVELERS MEDICARE",
            "identifier": "500009946",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2150774",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SUBMITTER NO.",
            "identifier": "353077",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PALMETTO MEDICARE",
            "identifier": "NP04703",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sunbury, OH

Sources for this page

Verify at the official NPI Registry.