Individual provider Active NPI

Shelley L Hogue, DPM

  • Foot & Ankle Surgery Podiatrist
  • Broken Arrow, OK
National Provider Identifier
1215197280
Registry record updated Oct 6, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
000812T Issued in IA
Practice address
800 W Boise Cir
Ste. 150
Broken Arrow, OK 74012-4906
Phone
(918) 274-1557
Fax
(918) 274-8557
NPI assigned
Jun 13, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 6, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Foot & Ankle Surgery Podiatrist 213ES0103X 000812T IA Primary

Addresses

Primary practice location

800 W Boise Cir
Ste. 150
Broken Arrow, OK 74012-4906

Mailing address

PO Box 3500
Dept No 618
Claremore, OK 74018-3500
Phone (918) 274-1557

Other names 1

  • Shelley L Farmer Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20111005000574 OK Practitioner - Podiatry 2062589849 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Restoration Foot and Ankle PLLCGroup PAC ID 8628155157, 3 clinicians

Practice addresses (Care Compare)

800 W Boise Cir
Suite 150
Broken Arrow, OK 74012-4932
Phone (918) 274-1557

Hospital & facility affiliations

  • Ascension St John Broken Arrow Hospital, Broken Arrow, OK, CCN 370235
  • Ascension St John Medical Center Hospital, Tulsa, OK, CCN 370114

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue97
Removal of nail tissue165
Removal or shaving of skin growth1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
000812TIAMDFoot & Ankle Surgery Podiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Restoration Foot & Ankle PLLC Foot & Ankle Surgery CurrentSince Jul 1, 2011 Accepting new patients
Restoration Foot & Ankle PLLC Foot & Ankle Surgery CurrentSince Jul 1, 2011 Accepting new patients
Northeast Iowa Podiatry PC Foot & Ankle Surgery PastSince Jun 20, 1997 Accepting new patients

Locations

800 W Boise Cir
Ste 150
Broken Arrow, OK 74012
Phone (918) 274-1557

Interoperability endpoints

  • Direct secure messaging: shelley.hogue@direct.stjohnhealthsystem.com
  • FHIR API: https://fhir.meditouchehr.com/api/fhir/r4/

Organizations & group practices 3

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.

Hospital & facility affiliations 3

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": "1213315200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1412553600000",
    "number": "1215197280",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3500",
            "address_2": "DEPT NO 618",
            "city": "CLAREMORE",
            "state": "OK",
            "postal_code": "740183500",
            "telephone_number": "918-274-1557",
            "fax_number": "918-274-8557"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 W BOISE CIR",
            "address_2": "STE. 150",
            "city": "BROKEN ARROW",
            "state": "OK",
            "postal_code": "740124906",
            "telephone_number": "918-274-1557",
            "fax_number": "918-274-8557"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOGUE",
        "first_name": "SHELLEY",
        "middle_name": "L",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-06-13",
        "last_updated": "2014-10-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "IA",
            "license": "000812T",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SHELLEY",
            "last_name": "FARMER",
            "middle_name": "L",
            "credential": "DPM",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Broken Arrow, OK

Sources for this page

Verify at the official NPI Registry.