Active NPI
Jane B. Gogan, PHD, ABPP
- Clinical Psychologist
- Middleton, WI
National Provider Identifier
1467648121
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 2571 057
- Practice address
- 3015 Woodland TRL
Middleton, WI 53562-1910 - Phone
- (608) 467-3412
- NPI assigned
- Sep 17, 2007
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 2571 057 | WI | Primary |
Addresses
Primary practice location
3015 Woodland TRL
Middleton, WI 53562-1910
Mailing address
3015 Woodland TRL
Middleton, WI 53562-1910
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)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2571 057 | WI | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1189987200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1585699200000",
"number": "1467648121",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3015 WOODLAND TRL",
"city": "MIDDLETON",
"state": "WI",
"postal_code": "535621910"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3015 WOODLAND TRL",
"city": "MIDDLETON",
"state": "WI",
"postal_code": "535621910",
"telephone_number": "608-467-3412"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GOGAN",
"first_name": "JANE",
"middle_name": "B.",
"credential": "PHD, ABPP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-09-17",
"last_updated": "2020-04-01",
"certification_date": "2020-04-01",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "WI",
"license": "2571 057",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Middleton, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.