Active NPI
Lee S Hogan, PA-C
- Medical Physician Assistant
- St George, UT
National Provider Identifier
1508962309
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Medical Physician Assistant
- License
- PA-09
- Practice address
- 1067 E Tabernacle St
Ste 7
St George, UT 84770-3163 - Phone
- (143) 563-4760
- Fax
- (143) 567-4009
- NPI assigned
- Sep 16, 2006
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Medical Physician Assistant | 363AM0700X | PA-09 | ID | Primary |
Addresses
Primary practice location
1067 E Tabernacle St
Ste 7
St George, UT 84770-3163
Mailing address
26 N 60 E
La Verkin, UT 84745-5505
Phone (143) 561-9151
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
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PA-09 | ID | MD | Medical Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1158364800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1508962309",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "26 N 60 E",
"city": "LA VERKIN",
"state": "UT",
"postal_code": "847455505",
"telephone_number": "143-561-9151"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1067 E TABERNACLE ST",
"address_2": "STE 7",
"city": "ST GEORGE",
"state": "UT",
"postal_code": "847703163",
"telephone_number": "143-563-4760",
"fax_number": "143-567-4009"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HOGAN",
"first_name": "LEE",
"middle_name": "S",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-09-16",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "363AM0700X",
"taxonomy_group": "",
"desc": "Physician Assistant, Medical",
"state": "ID",
"license": "PA-09",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in St George, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.