Individual provider Active NPI

Philip Fly Hogue, CRNA

  • Certified Registered Nurse Anesthetist
  • Jasper, AL
National Provider Identifier
1689633208
Registry record updated Oct 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
1-030499 Issued in AL
Practice address
3400 Highway 78 E
Jasper, AL 35501-8907
Phone
(205) 387-4741
Fax
(205) 221-5474
NPI assigned
Mar 22, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 9, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 1-030499 AL Primary

Addresses

Primary practice location

3400 Highway 78 E
Jasper, AL 35501-8907

Mailing address

PO Box 1427
Jasper, AL 35502-1427
Phone (205) 221-5454

Other identifiers 1

IdentifierTypeStateIssuer
00940873MedicaidAL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040727001454 AL Practitioner - Certified Registered Nurse Anesthetist (Crna) 6709856834 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cullman Regional Anesthesia Services LLC 34 clinicians

Practice addresses (Care Compare)

1912 Al Hwy 157
Cullman, AL 35058-0609
Phone (256) 737-2496

Hospital & facility affiliations

  • Cullman Regional Medical Center Hospital, Cullman, AL, CCN 010035

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
1-030499ALMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Cullman Regional Anesthesia Services LLC CurrentSince Apr 1, 2019 Accepting new patients
Medical Anesthesia Group, PA PastSince Feb 24, 1997 Accepting new patients
Ambulatory Anesthesia Associates of Montgomery, PC PastSince Aug 1, 2005 Accepting new patients
Health Care Authority for Baptist Health, an Affiliate of Uabhs Past Accepting new patients

Locations

1403 Wall St
Cullman, AL 35055
Phone (256) 734-9472

1912 AL Highway 157
Cullman, AL 35058
Phone (256) 737-2496

Organizations & group practices 4

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1142985600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1191888000000",
    "number": "1689633208",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1427",
            "city": "JASPER",
            "state": "AL",
            "postal_code": "355021427",
            "telephone_number": "205-221-5454",
            "fax_number": "205-221-5474"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3400 HIGHWAY 78 E",
            "city": "JASPER",
            "state": "AL",
            "postal_code": "355018907",
            "telephone_number": "205-387-4741",
            "fax_number": "205-221-5474"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOGUE",
        "first_name": "PHILIP",
        "middle_name": "FLY",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-22",
        "last_updated": "2007-10-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "AL",
            "license": "1-030499",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00940873",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jasper, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.