Individual provider Active NPI

Courtney B Hogan, ARNP

  • Pediatric Nurse Practitioner
  • St Petersburg, FL
National Provider Identifier
1508387143
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
ARNP9277241 Issued in FL
Practice address
601 5TH St S
2ND FLR
St Petersburg, FL 33701-4804
Phone
(727) 767-3333
Fax
(727) 767-8990
NPI assigned
Jul 5, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X ARNP9277241 FL Primary

Addresses

Primary practice location

601 5TH St S
2ND FLR
St Petersburg, FL 33701-4804

Mailing address

601 5TH St S
2ND FLR
St Petersburg, FL 33701-4804
Phone (727) 767-3333

Other identifiers 1

IdentifierTypeStateIssuer
ARNP9277241OtherFLSTATE LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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 1

Enrollment IDStateProvider typePAC IDDetails
I20171019003198 FL Practitioner - Nurse Practitioner 1355617234 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
All Children'S OB/GYN Specialists PastSince Jul 24, 2022 Accepting new patients

Interoperability endpoints

  • Direct secure messaging: chogan743048@direct.hopkinsmedicine.org

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1499212800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1508387143",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "601 5TH ST S",
            "address_2": "2ND FLR",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337014804",
            "telephone_number": "727-767-3333",
            "fax_number": "727-767-8990"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 5TH ST S",
            "address_2": "2ND FLR",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337014804",
            "telephone_number": "727-767-3333",
            "fax_number": "727-767-8990"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOGAN",
        "first_name": "COURTNEY",
        "middle_name": "B",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-07-05",
        "last_updated": "2022-07-21",
        "certification_date": "2021-11-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "FL",
            "license": "ARNP9277241",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "ARNP9277241",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in St Petersburg, FL

Sources for this page

Verify at the official NPI Registry.