NPIMap

Individual provider Active NPI

Susan M Hogue, C.N.P

  • Family Nurse Practitioner
  • Gregory, SD
National Provider Identifier
1841256047
Registry record updated Nov 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
CP000259 Issued in SD
Practice address
110 S Logan Ave Ste a
Gregory, SD 57533-1614
Phone
(605) 835-9611
Fax
(605) 835-8033
NPI assigned
Apr 25, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 15, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X CP000259 SD
Family Nurse Practitioner 363LF0000X 110371 NE
Family Nurse Practitioner 363LF0000X CP000259 SD Primary

Addresses

Primary practice location

110 S Logan Ave Ste a
Gregory, SD 57533-1614

Mailing address

110 S Logan Ave Ste a
Gregory, SD 57533-1614
Phone (605) 835-9611

Other identifiers 1

IdentifierTypeStateIssuer
6826970MedicaidSD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SD, NE2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20100127000516 SD Practitioner - Nurse Practitioner 3971645003 Reassigns benefits to 2 organizations
I20210630000659 NE Practitioner - Nurse Practitioner 3971645003 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Avera McKennanGroup PAC ID 0345157103, shared by 52 NPIs, 957 clinicians

Practice addresses (Care Compare)

110 S Logan Ave
Suite a
Gregory, SD 57533-1614
Phone (605) 835-9611

400 Park Ave
Gregory, SD 57533-1302
Phone (605) 835-8394

405 Whittecar Ave
Gregory, SD 57533-1340
Phone (605) 835-9611

730 Wilson St
Butte, NE 68722-3550
Phone (605) 835-9611

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0259SDMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Avera McKennan CurrentSince Mar 23, 2021 Accepting new patients
Avera McKennan CurrentSince Apr 1, 1999 Accepting new patients
Avera McKennan Current Accepting new patients
Avera McKennan CurrentSince Apr 1, 1999 Accepting new patients
Avera McKennan Current Accepting new patients
Avera McKennan Nurse Practitioner Past Accepting new patients

Locations

110 S Logan Ave
Gregory, SD 57533
Phone (605) 655-1220

110 S Logan Ave
Ste A
Gregory, SD 57533
Phone (605) 835-8394

Interoperability endpoints

  • Direct secure messaging: susan.hogue@avera.sdhealthlink.net

Organizations & group practices 6

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 9

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": "1145923200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731628800000",
    "number": "1841256047",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 S LOGAN AVE STE A",
            "city": "GREGORY",
            "state": "SD",
            "postal_code": "575331614",
            "telephone_number": "605-835-9611",
            "fax_number": "605-835-8033"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 S LOGAN AVE STE A",
            "city": "GREGORY",
            "state": "SD",
            "postal_code": "575331614",
            "telephone_number": "605-835-9611",
            "fax_number": "605-835-8033"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOGUE",
        "first_name": "SUSAN",
        "middle_name": "M",
        "credential": "C.N.P",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-25",
        "last_updated": "2024-11-15",
        "certification_date": "2024-11-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "SD",
            "license": "CP000259",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NE",
            "license": "110371",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "SD",
            "license": "CP000259",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6826970",
            "state": "SD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Gregory, SD

Sources for this page

Verify at the official NPI Registry.