Individual provider Active NPI

Christopher Daniel Hogan

  • Emergency Medicine Physician
  • Bonaire, GA
National Provider Identifier
1235794488
Registry record updated Feb 2, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
88418 Issued in GA
Practice address
216 Rustic Live Oak TRL
Bonaire, GA 31005-4230
Phone
(561) 329-6911
NPI assigned
May 2, 2019
Last updated
Feb 2, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 2, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Emergency Medicine Physician 207P00000X 88418 GA Primary

Addresses

Primary practice location

216 Rustic Live Oak TRL
Bonaire, GA 31005-4230

Mailing address

216 Rustic Live Oak TRL
Bonaire, GA 31005-4230
Phone (561) 329-6911

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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
I20211116001578 GA Practitioner - Emergency Medicine 9739411976 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Acs Primary Care Physicians - Southeast PCGroup PAC ID 5193620714, 409 clinicians

Practice addresses (Care Compare)

400 Charter Blvd
Macon, GA 31210-4831
Phone (478) 757-8200

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
88418GAMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Houston County Emergency Group, LLC Emergency Medicine Current Accepting new patients
Houston County Emergency Group, LLC Emergency Medicine CurrentSince Oct 10, 2021 Accepting new patients
Acs Primary Care Physicians - Southeast PC Emergency Medicine CurrentSince Sep 1, 2022 Accepting new patients

Locations

350 Hospital Dr
Macon, GA 31217
Phone (478) 751-0367

400 Charter Blvd
Macon, GA 31210
Phone (478) 757-6000

2151 W Spring St
Monroe, GA 30655
Phone (770) 267-1792

1120 Morningside Dr
Perry, GA 31069
Phone (478) 218-1706

1601 Watson Blvd
Warner Robins, GA 31093
Phone (478) 322-5155

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/14272/brand/70/csg/1/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, 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": "1556755200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643760000000",
    "number": "1235794488",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "216 RUSTIC LIVE OAK TRL",
            "city": "BONAIRE",
            "state": "GA",
            "postal_code": "310054230",
            "telephone_number": "561-329-6911"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "216 RUSTIC LIVE OAK TRL",
            "city": "BONAIRE",
            "state": "GA",
            "postal_code": "310054230",
            "telephone_number": "561-329-6911"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOGAN",
        "first_name": "CHRISTOPHER",
        "middle_name": "DANIEL",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-05-02",
        "last_updated": "2022-02-02",
        "certification_date": "2022-02-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "GA",
            "license": "88418",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bonaire, GA

Sources for this page

Verify at the official NPI Registry.