Michael Patrick Hogan, PT, MPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

3075 Issued in NH

Practice address

612 Tenney Mountain Hwy
Unit 3 Tenney MTN Plaza
Plymouth, NH 03264-3155

Phone

(603) 536-7777

Fax

(603) 536-7787

NPI assigned

May 15, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

State licenses

Practice roles

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.

• Baker Valley Sports & Physical Therapy, LLC

  • Physical Therapy Clinic/Center
  • Plymouth, NH
  • NPI 1285722348
  NPD (past) Authorized official
• White Mountain Physical Therapy LP

  • Physical Therapist
  • Lincoln, NH
  • NPI 1922031137
  NPD (past)

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

{
    "created_epoch": "1147651200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1206057600000",
    "number": "1194776070",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "612 TENNEY MOUNTAIN HWY",
            "address_2": "UNIT 3 TENNEY MTN PLAZA",
            "city": "PLYMOUTH",
            "state": "NH",
            "postal_code": "032643155",
            "telephone_number": "603-536-7777",
            "fax_number": "603-536-7787"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "612 TENNEY MOUNTAIN HWY",
            "address_2": "UNIT 3 TENNEY MTN PLAZA",
            "city": "PLYMOUTH",
            "state": "NH",
            "postal_code": "032643155",
            "telephone_number": "603-536-7777",
            "fax_number": "603-536-7787"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOGAN",
        "first_name": "MICHAEL",
        "middle_name": "PATRICK",
        "name_prefix": "Mr.",
        "credential": "PT, MPT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-15",
        "last_updated": "2008-03-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NH",
            "license": "3075",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BCBS",
            "identifier": "08Y008932NH01",
            "state": "NH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30394799",
            "state": "NH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kathleen Wood Hedberg, APRN
• Hhrecoveryservices
• Evelyn Hicks
• Jennifer L Highland, DO
• Pamela Reid Hixon, OTR/L
• Intermountain Conservative Health Care Inc
• Patricia Jabre
• James Scales DPM
• John J Jehl, M.D.
• John S Richards MD PA

• Physical Therapist in Plymouth, NH
• Providers in Plymouth, NH by specialty
• Physical Therapist in New Hampshire

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 21, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.