Individual provider Active NPI

Heather Del Villar Bogdanov, N.P.

  • Acute Care Nurse Practitioner
  • Duarte, CA
National Provider Identifier
1558534685
Registry record updated Nov 12, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
17636 Issued in CA
Practice address
1500 E. Duarte Road
Duarte, CA 91010
Phone
(626) 256-4673
NPI assigned
Apr 9, 2008
Last updated
Nov 12, 2020By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 12, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X NP 17636 CA
Acute Care Nurse Practitioner 363LA2100X 17636 CA Primary

Addresses

Primary practice location

1500 E. Duarte Road
Duarte, CA 91010

Mailing address

PO Box 512185
Los Angeles, CA 90051-0185

Other identifiers 4

IdentifierTypeStateIssuer
CNS 2814OtherCACLINICAL NURSE SPECIALIST
NP 17636OtherCANURSE PRACTITIONER LICENS
PHN 66386OtherCAPUBLIC HEALTHE NURSE
RN 617845OtherCAREGISTERED NURSE LICENSE

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address direct@cityofhope.direct-ci.com CITY OF HOPE MEDICAL FOUNDATION

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
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
17636CAMDChiropractor
NP 17636CAMDNurse Practitioner

Interoperability endpoints

  • Direct secure messaging: hbogdanov49618@cityofhope.direct-ci.com

NPI Registry JSON

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

{
    "created_epoch": "1207699200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1605139200000",
    "number": "1558534685",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 512185",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900510185"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 E. DUARTE ROAD",
            "city": "DUARTE",
            "state": "CA",
            "postal_code": "91010",
            "telephone_number": "626-256-4673"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOGDANOV",
        "first_name": "HEATHER",
        "middle_name": "DEL VILLAR",
        "name_prefix": "Mrs.",
        "credential": "N.P.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-04-09",
        "last_updated": "2020-11-12",
        "certification_date": "2020-11-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "NP 17636",
            "primary": false
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "CA",
            "license": "17636",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CLINICAL NURSE SPECIALIST",
            "identifier": "CNS 2814",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NURSE PRACTITIONER LICENS",
            "identifier": "NP 17636",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PUBLIC HEALTHE NURSE",
            "identifier": "PHN 66386",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGISTERED NURSE LICENSE",
            "identifier": "RN 617845",
            "state": "CA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "direct@cityofhope.direct-ci.com",
            "affiliation": "Y",
            "affiliationName": "CITY OF HOPE MEDICAL FOUNDATION",
            "address_1": "1500 E. Duarte Road",
            "city": "Duarte",
            "state": "CA",
            "country_code": "US",
            "postal_code": "91010",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Duarte, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.