Joanne Hogan, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

5601007805 Issued in MI

Practice address

200 Jefferson Ave SE
Grand Rapids, MI 49503-4502

Phone

(616) 685-6781

Fax

(616) 685-3064

NPI assigned

Jul 14, 2016

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Hometown Urgent Care of Michigan, P.C.

  dba Hometown Urgent Care

  • Urgent Care Clinic/Center
  • Huber Heights, OH
  • NPI 1790030385

  MI

  Medicare reassignment NPD
• Grand River Emergency Medical Group PLC

  • Emergency Medicine Physician
  • Grand Rapids, MI
  • NPI 1114929353
  Medicare reassignment
• Hometown Urgent Care of Michigan, P.C.

  dba WellNow Clinical Laboratory

  • Clinical Medical Laboratory
  • Kalamazoo, MI
  • NPI 1891469631
  NPD
• Hometown Urgent Care of Michigan, PC

  dba WellNow Clinical Laboratory

  • Clinical Medical Laboratory
  • Indianapolis, IN
  • NPI 1881358489
  NPD

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

{
    "created_epoch": "1468454400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1468454400000",
    "number": "1619320637",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3578",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495013578",
            "telephone_number": "616-685-6781",
            "fax_number": "616-685-3064"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 JEFFERSON AVE SE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495034502",
            "telephone_number": "616-685-6781",
            "fax_number": "616-685-3064"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOGAN",
        "first_name": "JOANNE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-07-14",
        "last_updated": "2016-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": "5601007805",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ronald Michael Hofmann, MD
• Jane Elizabeth Hofstra
• Katie Hofstra
• Grace Claire Hogan, CF-SLP
• Jessica Marie Hogan, BA, QIDP
• Marisa K Hogan
• Melissa Grace Hogan, PA
• Russell E Hogan, PHD
• Shelby Hogan, LMSW
• Vincent Hogan, PA-C

• Physician Assistant in Grand Rapids, MI
• Providers in Grand Rapids, MI by specialty
• Physician Assistant in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2016; 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.

Verify at the official NPI Registry.