Jacki Hogan, CNA

Primary specialty

Home Health AideTaxonomy code 374U00000X

License

85-0913687 Issued in ID

Practice address

725 Eve Dr
Idaho Falls, ID 83401-3606

Phone

(208) 390-4432

NPI assigned

Mar 22, 2019

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1553212800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1598745600000",
    "number": "1720548944",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "725 EVE DR",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834013606",
            "telephone_number": "208-390-4432"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "725 EVE DR",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834013606",
            "telephone_number": "208-390-4432"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOGAN",
        "first_name": "JACKI",
        "credential": "CNA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-03-22",
        "last_updated": "2020-08-30",
        "certification_date": "2020-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "374U00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Home Health Aide",
            "state": "ID",
            "license": "85-0913687",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "789joki@gmail.com",
            "affiliation": "N",
            "address_1": "725 Eve Dr",
            "city": "Idaho Falls",
            "state": "ID",
            "country_code": "US",
            "postal_code": "834013606",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Samantha Hodge-Tracy, LPC
• Barbara Hodges, LMSW
• Gene K. Hodges, M.D.
• Gregory R. Hodson, M.D.
• David Jon Hoffmann
• Megan Hogan
• Benjamin Loren Hogenson, LMSW
• Debra Hogg, M.S. CCC-SLP
• Victoria S Holdeman
• Hailey Holland, LMSW

• Home Health Aide in Idaho Falls, ID
• Providers in Idaho Falls, ID by specialty
• Home Health Aide in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.