Individual provider Active NPI

Ryan Hogan

  • Occupational Therapist
  • Wilmington, NC
National Provider Identifier
1326608258
Registry record updated Feb 7, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
11977 Issued in NC
Practice address
4130 Oleander Dr
Wilmington, NC 28403-6843
Phone
(910) 679-8385
NPI assigned
Jun 13, 2019
Last updated
Feb 7, 2024By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 7, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 11977 NC Primary

Addresses

Primary practice location

4130 Oleander Dr
Wilmington, NC 28403-6843

Mailing address

100 Brewster Blvd
Camp Lejeune, NC 28547-2575
Phone (203) 917-0122

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
11977NCMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Coastline Therapy Group, LLC Occupational Therapist CurrentSince Aug 20, 2019 Accepting new patients
Ivyrehab North Carolina LLC Past Accepting new patients
Coastal Speech and Reading Center PastSince Aug 20, 2019 Accepting new patients

Locations

3901 Wrightsville Ave
Ste 120
Wilmington, NC 28403

4130 Oleander Dr
Wilmington, NC 28403
Phone (910) 794-3929

4130 Oleander Dr
Ste 101
Wilmington, NC 28403

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.

NPI Registry JSON

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

{
    "created_epoch": "1560384000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707264000000",
    "number": "1326608258",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 BREWSTER BLVD",
            "city": "CAMP LEJEUNE",
            "state": "NC",
            "postal_code": "285472575",
            "telephone_number": "203-917-0122"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4130 OLEANDER DR",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284036843",
            "telephone_number": "910-679-8385"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOGAN",
        "first_name": "RYAN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-06-13",
        "last_updated": "2024-02-07",
        "certification_date": "2024-02-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NC",
            "license": "11977",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wilmington, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 2024; 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.