Active NPI
Stanley Lamar Hogan, BSRPH
- Pharmacist
- Jackson, GA
National Provider Identifier
1386083939
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- RPH011320
- Practice address
- 4 2ND St
Jackson, GA 30233-1920 - Phone
- (770) 775-3663
- Fax
- (770) 775-1279
- NPI assigned
- Jun 17, 2013
- Last updated
- Jun 17, 2013
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | RPH011320 | GA | Primary |
Addresses
Primary practice location
4 2ND St
Jackson, GA 30233-1920
Mailing address
299 James Moore Cir
P O Box 125
Jackson, GA 30233-2421
Phone (770) 775-3663
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00029807A | Medicaid | GA |
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
| License | State | Type | Specialty |
|---|---|---|---|
| RPH011320 | GA | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| RR Long Inc | 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, 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": "1371427200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1371427200000",
"number": "1386083939",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "299 JAMES MOORE CIR",
"address_2": "P O BOX 125",
"city": "JACKSON",
"state": "GA",
"postal_code": "302332421",
"telephone_number": "770-775-3663",
"fax_number": "770-775-1279"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4 2ND ST",
"city": "JACKSON",
"state": "GA",
"postal_code": "302331920",
"telephone_number": "770-775-3663",
"fax_number": "770-775-1279"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HOGAN",
"first_name": "STANLEY",
"middle_name": "LAMAR",
"name_prefix": "Mr.",
"credential": "BSRPH",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2013-06-17",
"last_updated": "2013-06-17",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "GA",
"license": "RPH011320",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00029807A",
"state": "GA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Jackson, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.