Carolyn Jane Bogan, FNP-BC

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

AP125985 Issued in TX

Practice address

6363 N State Highway 161 Ste 100
Irving, TX 75038-2239

Phone

(469) 200-3272

NPI assigned

May 28, 2014

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Carolyn Jane Hablitzel Former name

Medicare fee-for-service enrollment

Enrolled in TX

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: cbogan@landmarkhealth-direct.org

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.

• Ucp Physicians of Central Texas, PLLC

  dba Baylor Scott & White Urgent Care Plus

  • Urgent Care Clinic/Center
  • Georgetown, TX
  • NPI 1922289412
  Medicare reassignment NPD
• Ucp Physicians of Central Texas, PLLC

  dba Baylor Scott & White Urgent Care Plus

  • Urgent Care Clinic/Center
  • Austin, TX
  • NPI 1154472967
  NPD
• Chest Diagnostic Therapeutic SVCS & Transit Nursing of TX, Inc

  dba Chest Diagnostic Therapeutic Services, Inc

  • Durable Medical Equipment & Medical Supplies
  • Mexia, TX
  • NPI 1770589392
  NPD (past)

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

{
    "created_epoch": "1401235200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1624924800000",
    "number": "1770995649",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "409 MITCHELL RD",
            "city": "LORENA",
            "state": "TX",
            "postal_code": "766559418",
            "telephone_number": "254-744-8206",
            "fax_number": "254-857-4462"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6363 N STATE HIGHWAY 161 STE 100",
            "city": "IRVING",
            "state": "TX",
            "postal_code": "750382239",
            "telephone_number": "469-200-3272"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "409 Mitchell Rd",
            "address_purpose": "LOCATION",
            "city": "Lorena",
            "state": "TX",
            "postal_code": "766559418",
            "country_code": "US",
            "telephone_number": "254-744-8206",
            "fax_number": "254-857-4462",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BOGAN",
        "first_name": "CAROLYN",
        "middle_name": "JANE",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-05-28",
        "last_updated": "2021-06-29",
        "certification_date": "2021-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WP2201X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Ambulatory Care",
            "state": "TX",
            "license": "661649",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "AP125985",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CAROLYN",
            "last_name": "HABLITZEL",
            "middle_name": "JANE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Blueprint to Healthcare
• Boardwalk Providers Group LLC
• Corrie Rose Bober, MS, ATC, CES
• Bobs DME
• Aruna Boddu, MD
• Shawn Boggs, LMFT
• Dylan Bogucki, DNP-FNP
• Jo-Eprise Bohn-Sauveterre, M.S., SLP
• Robert Alan Bohnaker, PTA
• Devin Bohon, M.S. CCC-SLP

• Family Nurse Practitioner in Irving, TX
• Providers in Irving, TX by specialty
• Family Nurse Practitioner in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.