Organization Active NPI

Hogan and Broderson Chiropractic

Doing business as Malama Chiropractic Clinic

  • Chiropractor
  • Kailua Kona, HI
National Provider Identifier
1255483954
Registry record updated Jun 15, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
977 Issued in HI
Legal business name
HOGAN AND BRODERSON CHIROPRACTIC
Doing business as
Malama Chiropractic Clinic
Practice address
74-5620 Palani Rd Ste 102
Kailua Kona, HI 96740-3640
Phone
(808) 329-7797
Fax
(808) 329-2748
NPI assigned
Jan 16, 2007
Last updated
Jun 15, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 15, 2023

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

Authorized official

Name
Dr. Shannon Marie Hogan, D.C
Title
Doctor
Phone
(808) 329-7797

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 977 HI Primary

Addresses

Primary practice location

74-5620 Palani Rd Ste 102
Kailua Kona, HI 96740-3640

Mailing address

74-5620 Palani Rd Ste 102
Kailua Kona, HI 96740-3640
Phone (808) 329-7797

Other names 1

  • Malama Chiropractic Clinic Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in HI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040505000470 HI Part B Supplier - Clinic/Group Practice 8325036643 Receives reassigned benefits from 2 practitioners
Practice locations: Kailua Kona, HI

National Provider Directory

National Provider Directory

Locations

74-5620 Palani Rd
Ste 102
Kailua Kona, HI 96740
Phone (808) 329-7797

74-5620A Palani Rd
Ste 102
Kailua Kona, HI 96740
Phone (808) 215-6574

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1168905600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1686787200000",
    "number": "1255483954",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "74-5620 PALANI RD STE 102",
            "city": "KAILUA KONA",
            "state": "HI",
            "postal_code": "967403640",
            "telephone_number": "808-329-7797",
            "fax_number": "808-329-2748"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "74-5620 PALANI RD STE 102",
            "city": "KAILUA KONA",
            "state": "HI",
            "postal_code": "967403640",
            "telephone_number": "808-329-7797",
            "fax_number": "808-329-2748"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HOGAN AND BRODERSON CHIROPRACTIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-16",
        "last_updated": "2023-06-15",
        "certification_date": "2023-06-15",
        "status": "A",
        "authorized_official_last_name": "HOGAN",
        "authorized_official_first_name": "SHANNON",
        "authorized_official_middle_name": "MARIE",
        "authorized_official_title_or_position": "DOCTOR",
        "authorized_official_telephone_number": "808-329-7797",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "HI",
            "license": "977",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Malama Chiropractic Clinic",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Malama Chiropractic Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Kailua Kona, HI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.