Individual provider Active NPI

Lamicha M Hogan, FNPC

  • Nurse Practitioner
  • Lubbock, TX
National Provider Identifier
1174621536
Registry record updated Nov 26, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
642609 Issued in TX
Practice address
2002 Oxford Ave
Lubbock, TX 79410
Phone
(806) 793-8869
Fax
(806) 793-0043
NPI assigned
Sep 20, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 26, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 642609 TX Primary

Addresses

Primary practice location

2002 Oxford Ave
Lubbock, TX 79410

Mailing address

2002 Oxford Ave
Lubbock, TX 79410
Phone (806) 793-8869

Other identifiers 1

IdentifierTypeStateIssuer
178030601MedicaidTX

Other names 1

  • Lamicha M Ellis Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20060110001138 TX Practitioner - Nurse Practitioner 9830112390 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lynn County Hospital DistrictGroup PAC ID 9739149295, shared by 6 NPIs, 16 clinicians

Practice addresses (Care Compare)

2600 Lockwood St
Suite C
Tahoka, TX 79373-4118
Phone 8069984533320

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
642609TXMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Lynn County Hospital District Nurse Practitioner Current Accepting new patients
Lynn County Hospital District Nurse Practitioner Current Accepting new patients
Lynn County Hospital District Nurse Practitioner CurrentSince Mar 11, 2024 Accepting new patients
Lynn County Hospital District CurrentSince Mar 11, 2024 Accepting new patients
Lynn County Hospital District Past Accepting new patients
Lynn County Hospital District Nurse Practitioner Past Accepting new patients
Lynnwood Assisted Living Past Accepting new patients
Lynn County Hospital District Past Accepting new patients

Locations

1104 N Avenue S
Post, TX 79356
Phone (806) 495-2853

2600 Lockwood St
Tahoka, TX 79373
Phone (806) 998-4533

2600 Lockwood St
Ste C
Tahoka, TX 79373
Phone 8069984533322

Interoperability endpoints

  • Direct secure messaging: lamicha.hogan@direct.myteamcare.com

Organizations & group practices 8

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1158710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1196035200000",
    "number": "1174621536",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2002 OXFORD AVE",
            "city": "LUBBOCK",
            "state": "TX",
            "postal_code": "79410",
            "telephone_number": "806-793-8869",
            "fax_number": "806-793-0043"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2002 OXFORD AVE",
            "city": "LUBBOCK",
            "state": "TX",
            "postal_code": "79410",
            "telephone_number": "806-793-8869",
            "fax_number": "806-793-0043"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOGAN",
        "first_name": "LAMICHA",
        "middle_name": "M",
        "credential": "FNPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-20",
        "last_updated": "2007-11-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "TX",
            "license": "642609",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "178030601",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LAMICHA",
            "last_name": "ELLIS",
            "middle_name": "M",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Lubbock, TX

Sources for this page

Verify at the official NPI Registry.