Individual provider Active NPI

Courtney Marie Hogan, CRNP

  • Critical Care Medicine Clinical Nurse Specialist
  • Philadelphia, PA
National Provider Identifier
1487964615
Registry record updated Nov 24, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Critical Care Medicine Clinical Nurse SpecialistTaxonomy code 364SC0200X
License
SP014649 Issued in PA
Practice address
51 N 39TH St
2 Phi
Philadelphia, PA 19104-2640
Phone
(215) 662-9010
NPI assigned
Oct 21, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 24, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X 629550 NY
Critical Care Medicine Clinical Nurse Specialist 364SC0200X SP014649 PA Primary

Addresses

Primary practice location

51 N 39TH St
2 Phi
Philadelphia, PA 19104-2640

Mailing address

51 N 39TH St
2 Phi
Philadelphia, PA 19104-2640
Phone (215) 662-9010

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA, NJ2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20150401000534 PA Practitioner - Nurse Practitioner 7113175159 Reassigns benefits to 2 organizations
I20240709000551 NJ Practitioner - Nurse Practitioner 7113175159 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Clinical Health Care Associates of New Jersey PCGroup PAC ID 0749180198, shared by 7 NPIs, 793 clinicians

Practice addresses (Care Compare)

1006 Mantua Pike
Woodbury, NJ 08097-1221
Phone (856) 216-0300

51 N 39TH St 4 HVP
Penn Cardiology Penn Presbyterian 4TH Floor
Philadelphia, PA 19104-2640
Phone (215) 662-9189

Hospital & facility affiliations

  • Penn Presbyterian Medical Center Hospital, Philadelphia, PA, CCN 390223

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
629550NYMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Clinical Health Care Associates of New Jersey, PC CurrentSince Nov 30, 2015 Accepting new patients
Clinical Health Care Associates of New Jersey, P.C. CurrentSince Nov 30, 2015 Accepting new patients
Clinical Health Care Associates of New Jersey, PC Current Accepting new patients
Clinical Health Care Associates of New Jersey PC CurrentSince Apr 28, 2024 Accepting new patients
University of Penn - Medical Group CurrentSince Feb 16, 2015 Accepting new patients
University of Penn-Medical Group CurrentSince Feb 16, 2015 Accepting new patients

Locations

211 S Main St
Ste 205
Cape May Court House, NJ 08210
Phone (609) 463-0800

3205 Fire Rd
Egg Hbr Twp, NJ 08234
Phone (609) 407-1113

1006 Mantua Pike
Woodbury Hts, NJ 08097
Phone (856) 845-6880

7133 Roosevelt Blvd
Philadelphia, PA 19149
Phone (215) 333-3311

51 N 39th St
Fl 2
Philadelphia, PA 19104
Phone (215) 662-9010

51 N 39th St
Fl 4
Philadelphia, PA 19104
Phone (215) 662-9189

Organizations & group practices 6

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.

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": "1287619200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1448323200000",
    "number": "1487964615",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "51 N 39TH ST",
            "address_2": "2 PHI",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191042640",
            "telephone_number": "215-662-9010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "51 N 39TH ST",
            "address_2": "2 PHI",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191042640",
            "telephone_number": "215-662-9010"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOGAN",
        "first_name": "COURTNEY",
        "middle_name": "MARIE",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-10-21",
        "last_updated": "2015-11-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "NY",
            "license": "629550",
            "primary": false
        },
        {
            "code": "364SC0200X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Critical Care Medicine",
            "state": "PA",
            "license": "SP014649",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.