Individual provider Active NPI

William Hogan, PT

  • Physical Therapist
  • Avon, CT
National Provider Identifier
1336119692
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
006231 Issued in CT
Practice address
100 Simsbury Road
Eastern Rehabilitation Network 5TH Floor
Avon, CT 06001
Phone
(860) 674-0255
Fax
(860) 674-3727
NPI assigned
Jan 26, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 006231 CT Primary

Addresses

Primary practice location

100 Simsbury Road
Eastern Rehabilitation Network 5TH Floor
Avon, CT 06001

Mailing address

181 Patricia Genova Drive
Eastern Rehabilitation Network 5TH Floor
Newington, CT 06111
Phone (860) 667-5449

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
006231CTMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Eastern Rehabilitation Network Headache Clinic Physical Therapist Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1138233600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1336119692",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "181 PATRICIA GENOVA DRIVE",
            "address_2": "EASTERN REHABILITATION NETWORK 5TH FLOOR",
            "city": "NEWINGTON",
            "state": "CT",
            "postal_code": "06111",
            "telephone_number": "860-667-5449",
            "fax_number": "860-667-8416"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 SIMSBURY ROAD",
            "address_2": "EASTERN REHABILITATION NETWORK 5TH FLOOR",
            "city": "AVON",
            "state": "CT",
            "postal_code": "06001",
            "telephone_number": "860-674-0255",
            "fax_number": "860-674-3727"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOGAN",
        "first_name": "WILLIAM",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-26",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CT",
            "license": "006231",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Avon, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; 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.