Active NPI
Kerry L Hogan, PH.D.
- Cognitive & Behavioral Psychologist
- Wilmington, NC
National Provider Identifier
1679628648
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Cognitive & Behavioral Psychologist
- License
- 2968
- Practice address
- 3973B Market St
Wilmington, NC 28403-1403 - Phone
- (910) 763-0699
- Fax
- (910) 763-0489
- NPI assigned
- Jan 23, 2007
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 5
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 2968 | NC | |
| Clinical Child & Adolescent Psychologist | 103TC2200X | 2968 | NC | |
| Intellectual & Developmental Disabilities Psychologist | 103TM1800X | 2968 | NC | |
| Group Psychotherapy Psychologist | 103TP2701X | 2968 | NC | |
| Cognitive & Behavioral Psychologist | 103TB0200X | 2968 | NC | Primary |
Addresses
Primary practice location
3973B Market St
Wilmington, NC 28403-1403
Mailing address
3973B Market St
Wilmington, NC 28403-1403
Phone (910) 763-0699
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 6000934 | Medicaid | NC |
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
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2968 | NC | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1169510400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1757548800000",
"number": "1679628648",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3973B MARKET ST",
"city": "WILMINGTON",
"state": "NC",
"postal_code": "284031403",
"telephone_number": "910-763-0699",
"fax_number": "910-763-0489"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3973B MARKET ST",
"city": "WILMINGTON",
"state": "NC",
"postal_code": "284031403",
"telephone_number": "910-763-0699",
"fax_number": "910-763-0489"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HOGAN",
"first_name": "KERRY",
"middle_name": "L",
"credential": "PH.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-01-23",
"last_updated": "2025-09-11",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "NC",
"license": "2968",
"primary": false
},
{
"code": "103TC2200X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical Child & Adolescent",
"state": "NC",
"license": "2968",
"primary": false
},
{
"code": "103TM1800X",
"taxonomy_group": "",
"desc": "Psychologist, Intellectual & Developmental Disabilities",
"state": "NC",
"license": "2968",
"primary": false
},
{
"code": "103TP2701X",
"taxonomy_group": "",
"desc": "Psychologist, Group Psychotherapy",
"state": "NC",
"license": "2968",
"primary": false
},
{
"code": "103TB0200X",
"taxonomy_group": "",
"desc": "Psychologist, Cognitive & Behavioral",
"state": "NC",
"license": "2968",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "6000934",
"state": "NC"
}
],
"endpoints": [],
"other_names": []
}Other providers in Wilmington, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.