Jamal Hogan Sr., IDMT

Primary specialty

Independent Duty Medical TechniciansTaxonomy code 1710I1003X

Practice address

3322 Charles Blvd
108TH CRG
McGuire Afb, NJ 08641

Phone

(609) 754-0367

NPI assigned

Mar 19, 2014

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1395187200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1395187200000",
    "number": "1306263108",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "253 MONTCLAIR AVE FL 2",
            "city": "VAUXHALL",
            "state": "NJ",
            "postal_code": "070881316",
            "telephone_number": "973-508-8169"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3322 CHARLES BLVD",
            "address_2": "108TH CRG",
            "city": "MCGUIRE AFB",
            "state": "NJ",
            "postal_code": "08641",
            "telephone_number": "609-754-0367"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOGAN",
        "first_name": "JAMAL",
        "name_suffix": "Sr.",
        "credential": "IDMT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-03-19",
        "last_updated": "2014-03-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1710I1003X",
            "taxonomy_group": "",
            "desc": "Military Health Care Provider, Independent Duty Medical Technicians",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Eddie Anthony Colon, CCT, RCP
• Susan Davidson, PT
• William Warnick Dodson III, MD
• Cynthia B. Freier, LCSW
• Gary Alan Friedman, IDMT
• Harini Kumar, M.D.
• Sarah Jane Laney, IDMT
• National Vision, Inc.
• Tara Lynne Parker, R.N,B.S.N, APN, NP-C
• Nicole Pennock, IDMT

• All providers in McGuire Afb, NJ
• Independent Duty Medical Technicians in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 2014; 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.