Shannon Hogan, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

285094 Issued in MA

Practice address

195 Canal St
Malden, MA 02148-6701

Phone

(781) 338-0500

NPI assigned

May 7, 2020

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Interoperability endpoints

• Direct secure messaging: shannon.hogan.1@16251.direct.athenahealth.com

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

{
    "created_epoch": "1588809600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607126400000",
    "number": "1922620442",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "195 CANAL ST",
            "city": "MALDEN",
            "state": "MA",
            "postal_code": "021486701"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "195 CANAL ST",
            "city": "MALDEN",
            "state": "MA",
            "postal_code": "021486701",
            "telephone_number": "781-338-0500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOGAN",
        "first_name": "SHANNON",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-05-07",
        "last_updated": "2020-12-05",
        "certification_date": "2020-12-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MA",
            "license": "285094",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Grace Ho
• Michael S Ho, DMD
• Tom Ho, DMD
• Richard Alan Hochman, MD
• Ann Hogan, RN
• Vanessa Hogu, LCSW
• Anne-Marie Holland
• Dave Hollander, M.D.
• Margarida Cardoso Holmes
• Homily Care Agency Inc

• Family Medicine Physician in Malden, MA
• Providers in Malden, MA by specialty
• Family Medicine Physician in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2020; 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.