Individual provider Active NPI

William Mitchell Hogan, MD

  • Psychiatry Physician
  • Knoxville, TN
National Provider Identifier
1164527263
Registry record updated Jan 10, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
MD0000014221 Issued in TN
Practice address
1432 Hickey Rd
Knoxville, TN 37932-2017
Phone
(865) 539-4000
Fax
(865) 539-8215
NPI assigned
Sep 13, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 10, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X MD0000014221 TN Primary

Addresses

Primary practice location

1432 Hickey Rd
Knoxville, TN 37932-2017

Mailing address

PO Box 31649
Knoxville, TN 37930-1649
Phone (865) 539-4000

Other identifiers 3

IdentifierTypeStateIssuer
0021709OtherTNBCBST PROVIDER NUMBER
103970OtherTNVALUE OPTIONS PROVIDER ID
3197893MedicaidTN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040506001598 TN Practitioner - Psychiatry 1951390855 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
University of Alabama School of Medicine, 1970
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

1432 Hickey Rd
Knoxville, TN 37932-2017
Phone (865) 539-4000

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD0000014221TNMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Parkwest Medical Center Past Accepting new patients
Covenant Medical Group, Inc. Past Accepting new patients
Parkwest Medical Center Past Accepting new patients

Organizations & group practices 4

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": "1158105600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1484006400000",
    "number": "1164527263",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 31649",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379301649",
            "telephone_number": "865-539-4000",
            "fax_number": "865-539-8215"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1432 HICKEY RD",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379322017",
            "telephone_number": "865-539-4000",
            "fax_number": "865-539-8215"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOGAN",
        "first_name": "WILLIAM",
        "middle_name": "MITCHELL",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-13",
        "last_updated": "2017-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "TN",
            "license": "MD0000014221",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBST PROVIDER NUMBER",
            "identifier": "0021709",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VALUE OPTIONS PROVIDER ID",
            "identifier": "103970",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3197893",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Knoxville, TN

Sources for this page

Verify at the official NPI Registry.