Individual provider Active NPI

Tony Lynn Hogan, ARNP

  • Family Nurse Practitioner
  • Glasgow, KY
National Provider Identifier
1366610826
Registry record updated Jan 27, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
3005287 Issued in KY
Practice address
100 Reynolds Rd
Ste a
Glasgow, KY 42141-1127
Phone
(270) 651-6707
Fax
(270) 651-1751
NPI assigned
Feb 18, 2008
Last updated
Jan 27, 2021By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 27, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 5287P KY
Family Nurse Practitioner 363LF0000X 3005287 KY Primary

Addresses

Primary practice location

100 Reynolds Rd
Ste a
Glasgow, KY 42141-1127

Mailing address

100 Reynolds Rd
Ste a
Glasgow, KY 42141-1127
Phone (270) 651-6707

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20081229000499 KY Practitioner - Nurse Practitioner 3476615436 Practice locations: Glasgow, KY

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5287PKYMDNurse Practitioner
3005287KYMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
David C. German M.D., PSC Past Accepting new patients
My 3 C's Enterprises, PLLC Past Accepting new patients

Organizations & group practices 2

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": "1203292800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1611705600000",
    "number": "1366610826",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 REYNOLDS RD",
            "address_2": "STE A",
            "city": "GLASGOW",
            "state": "KY",
            "postal_code": "421411127",
            "telephone_number": "270-651-6707",
            "fax_number": "270-651-1751"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 REYNOLDS RD",
            "address_2": "STE A",
            "city": "GLASGOW",
            "state": "KY",
            "postal_code": "421411127",
            "telephone_number": "270-651-6707",
            "fax_number": "270-651-1751"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOGAN",
        "first_name": "TONY",
        "middle_name": "LYNN",
        "name_prefix": "Mr.",
        "credential": "ARNP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-02-18",
        "last_updated": "2021-01-27",
        "certification_date": "2021-01-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "KY",
            "license": "5287P",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "KY",
            "license": "3005287",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glasgow, KY

Sources for this page

Verify at the official NPI Registry.