Active NPI
Brently Shane Hogan, PT, DPT
- Physical Therapist
- Monroe, LA
National Provider Identifier
1740201870
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 06610
- Practice address
- 1123 Forsythe Ave
Monroe, LA 71201-4307 - Phone
- (318) 322-9980
- Fax
- (318) 322-9946
- NPI assigned
- Jul 22, 2006
- 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 |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 06610 | LA | Primary |
Addresses
Primary practice location
1123 Forsythe Ave
Monroe, LA 71201-4307
Mailing address
1123 Forsythe Ave
Monroe, LA 71201-4307
Phone (318) 322-9980
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 06610 | LA | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Hogan Therapy Associates Inc. | Physical Therapist | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Physical Therapist
- Monroe, LA
- NPI 1669493797
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153526400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1740201870",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1123 FORSYTHE AVE",
"city": "MONROE",
"state": "LA",
"postal_code": "712014307",
"telephone_number": "318-322-9980",
"fax_number": "318-322-9946"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1123 FORSYTHE AVE",
"city": "MONROE",
"state": "LA",
"postal_code": "712014307",
"telephone_number": "318-322-9980",
"fax_number": "318-322-9946"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HOGAN",
"first_name": "BRENTLY",
"middle_name": "SHANE",
"credential": "PT, DPT",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-07-22",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "LA",
"license": "06610",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Monroe, LA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.