Individual provider Active NPI

Mark Hogenson, MD

  • Family Medicine Physician
  • Cedar Rapids, IA
National Provider Identifier
1740258235
Registry record updated Oct 25, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
20654 Issued in IA
Practice address
3933 Mount Vernon Rd SE
Cedar Rapids, IA 52403-3869
Phone
(319) 363-8148
Fax
(319) 363-9118
NPI assigned
Mar 9, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 25, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 20654 IA Primary

Addresses

Primary practice location

3933 Mount Vernon Rd SE
Cedar Rapids, IA 52403-3869

Mailing address

PO Box 1824
Cedar Rapids, IA 52406-1824
Phone (319) 369-4505

Other identifiers 1

IdentifierTypeStateIssuer
1161497MedicaidIA

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
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
20654IAMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1141862400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1193270400000",
    "number": "1740258235",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1824",
            "city": "CEDAR RAPIDS",
            "state": "IA",
            "postal_code": "524061824",
            "telephone_number": "319-369-4505",
            "fax_number": "319-369-4677"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3933 MOUNT VERNON RD SE",
            "city": "CEDAR RAPIDS",
            "state": "IA",
            "postal_code": "524033869",
            "telephone_number": "319-363-8148",
            "fax_number": "319-363-9118"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOGENSON",
        "first_name": "MARK",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-09",
        "last_updated": "2007-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IA",
            "license": "20654",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1161497",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cedar Rapids, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 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.

Verify at the official NPI Registry.