Active NPI
Audrey Katherine Bogue, RD
- Registered Dietitian
- Lufkin, TX
National Provider Identifier
1144879420
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- DT84911
- Practice address
- 505 S John Redditt Dr
Lufkin, TX 75904-3120 - Phone
- (214) 476-8547
- NPI assigned
- Sep 9, 2019
- Last updated
- Sep 9, 2019
- 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 |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | DT84911 | TX | Primary |
Addresses
Primary practice location
505 S John Redditt Dr
Lufkin, TX 75904-3120
Mailing address
505 S John Redditt Dr
Lufkin, TX 75904-3120
Phone (214) 476-8547
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DT84911 | TX | MD | Registered Dietitian |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1567987200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1567987200000",
"number": "1144879420",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "505 S JOHN REDDITT DR",
"city": "LUFKIN",
"state": "TX",
"postal_code": "759043120",
"telephone_number": "214-476-8547"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "505 S JOHN REDDITT DR",
"city": "LUFKIN",
"state": "TX",
"postal_code": "759043120",
"telephone_number": "214-476-8547"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BOGUE",
"first_name": "AUDREY",
"middle_name": "KATHERINE",
"credential": "RD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-09-09",
"last_updated": "2019-09-09",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "TX",
"license": "DT84911",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lufkin, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 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.