Jamie Lynn Hogan, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

1595 Issued in SC

Practice address

2085 Henry Tecklenburg Dr
Charleston, SC 29414-7710

Phone

(843) 577-6523

NPI assigned

Nov 30, 2010

Sex

Female

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

Enrolled in SC

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

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

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.

• Bon Secours St Francis Xavier Hospital, Inc.

  • Emergency Medicine Physician
  • Charleston, SC
  • NPI 1770867442
  Medicare reassignment
• Bon Secours St. Francis Xavier Hospital, Inc.

  • Pediatrics Physician
  • Charleston, SC
  • NPI 1982583068
  NPD

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

{
    "created_epoch": "1291075200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1668038400000",
    "number": "1376845164",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 751874",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282751874",
            "telephone_number": "843-402-5200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2085 HENRY TECKLENBURG DR",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294147710",
            "telephone_number": "843-577-6523"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOGAN",
        "first_name": "JAMIE",
        "middle_name": "LYNN",
        "name_prefix": "Mrs.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-11-30",
        "last_updated": "2022-11-10",
        "certification_date": "2022-11-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "SC",
            "license": "1595",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Randi Jo Hoffmann, R.N.
• Shanda Retta Mae Hofmann, FNP-BC
• Lydia Rose Hofstetter
• Austin James Hogan, MD
• Charlene T Hogan, FNP-C
• Kathy R. Hogan, PHARM.D.
• Gina Lynn Hogg, PA-C
• James Alexander Hogg, PA-C, L.AC.
• Rachel Holbert, NP
• David Lindsay Holbrook, MD

• Physician Assistant in Charleston, SC
• Providers in Charleston, SC by specialty
• Physician Assistant in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 2022; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.