Active NPI
Shannon Nicole Hogan
- Family Nurse Practitioner
- Elizabeth City, NC
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 5011082
- Practice address
- 1144 N Road St
Elizabeth City, NC 27909-3473 - Phone
- (252) 335-0531
- NPI assigned
- Oct 2, 2018
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Critical Care Medicine Registered Nurse | 163WC0200X | 0001270844 | VA | |
| Family Nurse Practitioner | 363LF0000X | 5011082 | NC | Primary |
Addresses
Primary practice location
1144 N Road St
Elizabeth City, NC 27909-3473
Mailing address
5112 Clear Lake Cir
Virginia Beach, VA 23464-6028
Phone (443) 807-6012
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NC, MD, DC, CT
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 4
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- Other, 2018
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
1 California St
Suite 2300
San Francisco, CA 94111-3720
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5011082 | NC | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Medstar Urgent Care LLC | Current | Accepting new patients | |
| Medstar Urgent Care, LLC | Current | Accepting new patients | |
| Medstar Urgent Care LLC | Current | Accepting new patients | |
| Medstar Urgent Care LLC | Current | Accepting new patients | |
| Waterway Emergency Physicians LLC | Past | Accepting new patients |
Locations
6317 York Rd
Baltimore, MD 21212
Phone (443) 777-6890
12 Medstar Blvd
Bel Air, MD 21015
Phone (410) 877-8087
3064 Waldorf Market Pl
Waldorf, MD 20603
Phone (301) 932-5960
11915 Georgia Ave
Wheaton, MD 20902
Phone (301) 942-4505
Interoperability endpoints
- shannon.hogan.1@30520.direct.athenahealth.com
Organizations & group practices 6
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.
-
- Urgent Care Clinic/Center
- Baltimore, MD
- NPI 1902175870
-
- Family Medicine Physician
- San Francisco, CA
- NPI 1174931448
CT, NC
-
- General Practice Physician
- Lexington Park, MD
- NPI 1275410474
-
- Urgent Care Clinic/Center
- Baltimore, MD
- NPI 1942623319
-
- Emergency Medicine Physician
- Elizabeth City, NC
- NPI 1487804670
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1538438400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1538784000000",
"number": "1356826705",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5112 CLEAR LAKE CIR",
"city": "VIRGINIA BEACH",
"state": "VA",
"postal_code": "234646028",
"telephone_number": "443-807-6012"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1144 N ROAD ST",
"city": "ELIZABETH CITY",
"state": "NC",
"postal_code": "279093473",
"telephone_number": "252-335-0531"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HOGAN",
"first_name": "SHANNON",
"middle_name": "NICOLE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-10-02",
"last_updated": "2018-10-06",
"status": "A"
},
"taxonomies": [
{
"code": "163WC0200X",
"taxonomy_group": "",
"desc": "Registered Nurse, Critical Care Medicine",
"state": "VA",
"license": "0001270844",
"primary": false
},
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "NC",
"license": "5011082",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Elizabeth City, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 6, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.