Individual provider Active NPI

Ann M Bogue, FNP

  • Family Nurse Practitioner
  • Indianapolis, IN
National Provider Identifier
1437533320
Registry record updated Oct 31, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
71005573A Issued in IN
Practice address
6401 E Washington St
Indianapolis, IN 46219
Phone
(317) 808-7085
Fax
(317) 708-0115
NPI assigned
Jul 10, 2015
Last updated
Oct 31, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 31, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 209013786 IL
Family Nurse Practitioner 363LF0000X 71005573A IN Primary

Addresses

Primary practice location

6401 E Washington St
Indianapolis, IN 46219

Mailing address

PO Box 746720
Atlanta, GA 30374-6720
Phone (312) 733-9730

Other practice location 1

429 W Lincoln Rd
Kokomo, IN 46902-3508
Phone (765) 453-5600 ext. 245

Other identifiers 1

IdentifierTypeStateIssuer
201308690MedicaidIN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
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
I20150729008805 IN Practitioner - Nurse Practitioner 6800100207 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2015
Medicare assignment
May accept Medicare assignment
Group practices
Osh-in Physicians Group PCGroup PAC ID 6800100512, 62 clinicians

Practice addresses (Care Compare)

6401 E Washington St
Indy Irvington Clinic
Indianapolis, IN 46219-6614
Phone (317) 808-7085

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
71005573AINMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Osh-in Physicians Group, PC Family CurrentSince Oct 21, 2024 Accepting new patients
Oak Street Health Physicians Group, PC Family Past Accepting new patients

Locations

6401 E Washington St
Indianapolis, IN 46219
Phone (317) 662-3755

5926 Crawfordsville Rd
#B
Speedway, IN 46224
Phone (317) 653-2730

Interoperability endpoints

  • Direct secure messaging: ms_abogue@landmarkhealth-direct.org

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1436486400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730332800000",
    "number": "1437533320",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 746720",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303746720",
            "telephone_number": "312-733-9730",
            "fax_number": "312-929-0373"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6401 E WASHINGTON ST",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "46219",
            "telephone_number": "317-808-7085",
            "fax_number": "317-708-0115"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "429 W Lincoln Rd",
            "address_purpose": "LOCATION",
            "city": "Kokomo",
            "state": "IN",
            "postal_code": "469023508",
            "country_code": "US",
            "telephone_number": "765-453-5600 x245",
            "fax_number": "765-455-0110",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BOGUE",
        "first_name": "ANN",
        "middle_name": "M",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-07-10",
        "last_updated": "2024-10-31",
        "certification_date": "2024-10-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209013786",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IN",
            "license": "71005573A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201308690",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Indianapolis, IN

Sources for this page

Verify at the official NPI Registry.