Individual provider Active NPI

Barbara Kay Ogle, PA-C

  • Surgical Physician Assistant
  • Grand Rapids, MI
National Provider Identifier
1912097650
Registry record updated Aug 17, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
5601001711 Issued in MI
Practice address
145 Michigan St NE
Suite 5500
Grand Rapids, MI 49503-2562
Phone
(616) 267-8540
Fax
(616) 458-6230
NPI assigned
Oct 13, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 17, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X 5601001711 MI Primary

Addresses

Primary practice location

145 Michigan St NE
Suite 5500
Grand Rapids, MI 49503-2562

Mailing address

100 Michigan St NE
MC 845
Grand Rapids, MI 49503-2560

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
Physician Assistant

State licenses

LicenseStateTypeSpecialty
5601001711MIMDSurgical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Michigan Medical Patient Care Past Accepting new patients
Michigan Medical Patient Care Past Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1160697600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1471392000000",
    "number": "1912097650",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 MICHIGAN ST NE",
            "address_2": "MC 845",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495032560"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "145 MICHIGAN ST NE",
            "address_2": "SUITE 5500",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495032562",
            "telephone_number": "616-267-8540",
            "fax_number": "616-458-6230"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OGLE",
        "first_name": "BARBARA",
        "middle_name": "KAY",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-13",
        "last_updated": "2016-08-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "MI",
            "license": "5601001711",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Rapids, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 2016; 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.