Active NPI
Tim Hogan
- Mental Health Counselor
- Albuquerque, NM
National Provider Identifier
1639483597
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- Practice address
- 5301 Ponderosa Ave NE
Albuquerque, NM 87110-1216 - Phone
- (505) 881-8982
- NPI assigned
- Aug 3, 2010
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | Primary |
Addresses
Primary practice location
5301 Ponderosa Ave NE
Albuquerque, NM 87110-1216
Mailing address
1764 Lee Loop NE
Rio Rancho, NM 87144-5472
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)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1280793600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1280793600000",
"number": "1639483597",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1764 LEE LOOP NE",
"city": "RIO RANCHO",
"state": "NM",
"postal_code": "871445472"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5301 PONDEROSA AVE NE",
"city": "ALBUQUERQUE",
"state": "NM",
"postal_code": "871101216",
"telephone_number": "505-881-8982"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HOGAN",
"first_name": "TIM",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2010-08-03",
"last_updated": "2010-08-03",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Albuquerque, NM
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.