Active NPI
Mallory Rae Hogan, CNP
- Nurse Practitioner
- Sioux Falls, SD
National Provider Identifier
1487139374
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- CP001457
- Practice address
- 4520 W 69TH St
Sioux Falls, SD 57108-8148 - Phone
- (605) 977-5000
- Fax
- (605) 977-5377
- NPI assigned
- Sep 26, 2018
- 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 |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | CP001457 | SD | Primary |
Addresses
Primary practice location
4520 W 69TH St
Sioux Falls, SD 57108-8148
Mailing address
8805 W 18TH St
Sioux Falls, SD 57106-7596
Phone (056) 941-1240
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in SD, IA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 2
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- Other, 2018
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
116 E 10TH St
Suite 101
Spencer, IA 51301-4365
Phone (712) 264-3500
4500 W 69TH St
Sioux Falls, SD 57108-8148
4520 W 69TH St
Sioux Falls, SD 57108-8148
Phone (605) 977-5000
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Certified Nurse Practitioner, Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| CP001457 | SD | MD | Nurse Practitioner |
Interoperability endpoints
- mallory.hogan@avera.sdhealthlink.net
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 and National Provider Directory roles.
-
- Cardiovascular Disease Physician
- Sioux Falls, SD
- NPI 1407109705
IA
Hospital & facility affiliations 30
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Sioux Falls, SD
- NPI 1154531630
-
- General Acute Care Hospital
- Sioux Falls, SD
- NPI 1184834764
-
- Endocrinology, Diabetes & Metabolism Physician
- Sioux Falls, SD
- NPI 1396711016
Hospital
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1537920000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1712188800000",
"number": "1487139374",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8805 W 18TH ST",
"city": "SIOUX FALLS",
"state": "SD",
"postal_code": "571067596",
"telephone_number": "056-941-1240"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4520 W 69TH ST",
"city": "SIOUX FALLS",
"state": "SD",
"postal_code": "571088148",
"telephone_number": "605-977-5000",
"fax_number": "605-977-5377"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HOGAN",
"first_name": "MALLORY",
"middle_name": "RAE",
"name_prefix": "Mrs.",
"credential": "CNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-09-26",
"last_updated": "2024-04-04",
"certification_date": "2024-04-04",
"status": "A"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "SD",
"license": "CP001457",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Sioux Falls, SD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 4, 2024; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.