Individual provider Active NPI

John Gregory Pogue, MD

  • Psychiatry Physician
  • Tyler, TX
National Provider Identifier
1225068695
Registry record updated Feb 18, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
K9390 Issued in TX
Practice address
4101 University Blvd
Tyler, TX 75701-6623
Phone
(903) 266-2200
Fax
(903) 266-2398
NPI assigned
Jul 3, 2006
Last updated
Feb 18, 2010By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 18, 2010

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 K9390 TX Primary

Addresses

Primary practice location

4101 University Blvd
Tyler, TX 75701-6623

Mailing address

901 Turtle Creek Dr
Tyler, TX 75701-1947
Phone (903) 596-3588

Other identifiers 2

IdentifierTypeStateIssuer
260050530OtherMEDICARE RR
60863003MedicaidTX

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100301000569 TX Practitioner - Psychiatry 0446395560 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
University of Texas Medical School at Houston, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

102 W Henderson St
Ut Health Northeast Overton
Overton, TX 75684-1613
Phone (903) 834-0201

11937 US Hwy 271
Tyler, TX 75708-3154
Phone (903) 877-7200

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
University of Texas Health Science Center at Tyler-Facility-Physician CurrentSince Oct 1, 2019 Accepting new patients
Etmc Physician Group Inc. CurrentSince Mar 1, 2018 Accepting new patients
Etmc Physician Group Inc. CurrentSince Mar 1, 2018 Accepting new patients
University of Texas Health Science Center at Tyler-Facilty-Physician CurrentSince Oct 1, 2019 Accepting new patients
University of Texas Health Science Center at Tyler Past Accepting new patients

Locations

18118 FM 344 W
Flint, TX 75762
Phone (903) 825-3292

102 W Henderson St
Overton, TX 75684
Phone (903) 834-0201

1000 S Beckham Ave
Tyler, TX 75701
Phone (903) 526-1068

4101 University Blvd
Tyler, TX 75701
Phone (903) 266-2200

901 Turtle Creek Dr
Tyler, TX 75701
Phone (903) 594-2418

Interoperability endpoints

  • Direct secure messaging: jpogue355044@ahs.direct-ci.com

Organizations & group practices 5

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 1

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": "1151884800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1266451200000",
    "number": "1225068695",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "901 TURTLE CREEK DR",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757011947",
            "telephone_number": "903-596-3588",
            "fax_number": "903-594-2038"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4101 UNIVERSITY BLVD",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757016623",
            "telephone_number": "903-266-2200",
            "fax_number": "903-266-2398"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POGUE",
        "first_name": "JOHN",
        "middle_name": "GREGORY",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-03",
        "last_updated": "2010-02-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "TX",
            "license": "K9390",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RR",
            "identifier": "260050530",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "60863003",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tyler, TX

Sources for this page

Verify at the official NPI Registry.