Individual provider Active NPI

Nancy Bogdanovic, FNP-C

  • Family Nurse Practitioner
  • Conroe, TX
National Provider Identifier
1669986840
Registry record updated Apr 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
95008020 Issued in CA
Practice address
3421 W Davis St Ste 150
Conroe, TX 77304-1848
Phone
(936) 339-2373
Fax
(936) 249-0318
NPI assigned
Nov 26, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 17, 2025

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

Specialties & licenses 10

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 600435 CA
Administrator Registered Nurse 163WA2000X 600435 CA
Community Health Registered Nurse 163WC1500X 600435 CA
Hospice Registered Nurse 163WH1000X 600435 CA
Community Based Hospice Care Agency 251G00000X
Acute Care Nurse Practitioner 363LA2100X 95008020 CA
Adult Health Nurse Practitioner 363LA2200X 95008020 CA
Community Health Nurse Practitioner 363LC1500X 95008020 CA
Primary Care Nurse Practitioner 363LP2300X 95008020 CA
Family Nurse Practitioner 363LF0000X 95008020 CA Primary

Addresses

Primary practice location

3421 W Davis St Ste 150
Conroe, TX 77304-1848

Mailing address

2605 Woods Estates Dr
Conroe, TX 77304-4873
Phone (310) 987-0862

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
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.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
600435CAMDHospice Registered Nurse
95008020CAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Samson Healthcare, LLC Hospice CurrentSince Apr 20, 2025 Accepting new patients
La Vida Hospice, Inc. Hospice Care, Community Based PastSince Jun 1, 2023 Accepting new patients

Locations

3421 W Davis St
Ste 150
Conroe, TX 77304
Phone (936) 339-2373

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": "1511654400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744848000000",
    "number": "1669986840",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2605 WOODS ESTATES DR",
            "city": "CONROE",
            "state": "TX",
            "postal_code": "773044873",
            "telephone_number": "310-987-0862"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3421 W DAVIS ST STE 150",
            "city": "CONROE",
            "state": "TX",
            "postal_code": "773041848",
            "telephone_number": "936-339-2373",
            "fax_number": "936-249-0318"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOGDANOVIC",
        "first_name": "NANCY",
        "name_prefix": "Mrs.",
        "credential": "FNP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-11-26",
        "last_updated": "2025-04-17",
        "certification_date": "2025-04-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CA",
            "license": "600435",
            "primary": false
        },
        {
            "code": "163WA2000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Administrator",
            "state": "CA",
            "license": "600435",
            "primary": false
        },
        {
            "code": "163WC1500X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Community Health",
            "state": "CA",
            "license": "600435",
            "primary": false
        },
        {
            "code": "163WH1000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Hospice",
            "state": "CA",
            "license": "600435",
            "primary": false
        },
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "CA",
            "license": "95008020",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "CA",
            "license": "95008020",
            "primary": false
        },
        {
            "code": "363LC1500X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Community Health",
            "state": "CA",
            "license": "95008020",
            "primary": false
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "CA",
            "license": "95008020",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95008020",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Conroe, TX

Sources for this page

Verify at the official NPI Registry.