Active NPI
Carla Hogan
- Nurse Practitioner
- Broomall, PA
National Provider Identifier
1508233446
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- SP015220
- Practice address
- 20 Kimberly Way
Broomall, PA 19008-1057 - Phone
- (445) 345-1953
- NPI assigned
- Aug 26, 2015
- 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 | SP015220 | PA | Primary |
Addresses
Primary practice location
20 Kimberly Way
Broomall, PA 19008-1057
Mailing address
20 Kimberly Way
Broomall, PA 19008-1057
Phone (445) 345-1953
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in PA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| SP015220 | PA | MD | Nurse Practitioner |
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.
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- Harrisburg, PA
- NPI 1720796196
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1440547200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1673308800000",
"number": "1508233446",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "20 KIMBERLY WAY",
"city": "BROOMALL",
"state": "PA",
"postal_code": "190081057",
"telephone_number": "445-345-1953"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "20 KIMBERLY WAY",
"city": "BROOMALL",
"state": "PA",
"postal_code": "190081057",
"telephone_number": "445-345-1953"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HOGAN",
"first_name": "CARLA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-08-26",
"last_updated": "2023-01-10",
"certification_date": "2023-01-10",
"status": "A"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "PA",
"license": "SP015220",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Broomall, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2023; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.