Individual provider Active NPI

Maudray Montgomery Hogan

  • Case Manager/Care Coordinator
  • Oceanside, CA
National Provider Identifier
1457100257
Registry record updated May 14, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Case Manager/Care CoordinatorTaxonomy code 171M00000X
Practice address
2122 S El Camino Real Ste 102
Oceanside, CA 92054-6209
Phone
(760) 290-8170
NPI assigned
May 14, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 14, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Case Manager/Care Coordinator 171M00000X Primary

Addresses

Primary practice location

2122 S El Camino Real Ste 102
Oceanside, CA 92054-6209

Mailing address

2122 S El Camino Real Ste 102
Oceanside, CA 92054-6209
Phone (760) 290-8170

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

NPI Registry JSON

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

{
    "created_epoch": "1715644800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715644800000",
    "number": "1457100257",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2122 S EL CAMINO REAL STE 102",
            "city": "OCEANSIDE",
            "state": "CA",
            "postal_code": "920546209",
            "telephone_number": "760-290-8170"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2122 S EL CAMINO REAL STE 102",
            "city": "OCEANSIDE",
            "state": "CA",
            "postal_code": "920546209",
            "telephone_number": "760-290-8170"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOGAN",
        "first_name": "MAUDRAY",
        "middle_name": "MONTGOMERY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-05-14",
        "last_updated": "2024-05-14",
        "certification_date": "2024-05-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oceanside, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.