Mary Lynn Hogan, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

2005034573 Issued in MO

Practice address

1240 N Butterfield Rd
Bolivar, MO 65613-3016

Phone

(417) 326-6021

Fax

(417) 326-6347

NPI assigned

Jun 3, 2006

Sex

Female

Sole proprietor

No

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.

• Citizens Memorial Healthcare

  • Surgery Physician
  • Bolivar, MO
  • NPI 1568566131

  Family Medicine, MO

  Medicare reassignment Care Compare group NPD
• Citizens Memorial Healthcare

  • Rural Health Clinic/Center
  • Willard, MO
  • NPI 1568127397
  Care Compare group NPD
• Cherry Health Center, LLC

  • Physical Therapist
  • Springfield, MO
  • NPI 1770628620
  Care Compare group
• Citizens Memorial Healthcare

  • Rural Health Clinic/Center
  • Bolivar, MO
  • NPI 1063588960
  Care Compare group
• Citizens Memorial Healthcare

  • Rural Health Clinic/Center
  • Bolivar, MO
  • NPI 1407141153
  Care Compare group
• Citizens Memorial Healthcare

  • Rural Health Clinic/Center
  • Ash Grove, MO
  • NPI 1417161449
  Care Compare group
• Citizens Memorial Healthcare

  • Rural Health Clinic/Center
  • Stockton, MO
  • NPI 1447464227
  Care Compare group
• Citizens Memorial Healthcare

  • Rural Health Clinic/Center
  • Humansville, MO
  • NPI 1508070269
  Care Compare group
• Citizens Memorial Healthcare

  • Rural Health Clinic/Center
  • Osceola, MO
  • NPI 1578961454
  Care Compare group
• Citizens Memorial Healthcare

  • Rural Health Clinic/Center
  • Buffalo, MO
  • NPI 1609080571
  Care Compare group
• Citizens Memorial Healthcare

  • Rural Health Clinic/Center
  • Greenfield, MO
  • NPI 1699989350
  Care Compare group
• Citizens Memorial Healthcare

  • Rural Health Clinic/Center
  • Pleasant Hope, MO
  • NPI 1740494541
  Care Compare group

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Citizens Memorial Health Care Foundation

  • Community Based Hospice Care Agency
  • Bolivar, MO
  • NPI 1124157169

  Hospice

  Care Compare affiliation
• Citizens Memorial Health Care Foundation

  • Home Health Agency
  • Bolivar, MO
  • NPI 1376672238
  Care Compare affiliation
• Citizens Memorial Hospital District

  • General Acute Care Hospital
  • Bolivar, MO
  • NPI 1003981549

  Hospital

  Care Compare affiliation

Specialty

Family Practice

Education

University of Missouri, Columbia School of Medicine, 2003

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Citizens Memorial Healthcare 144 clinicians

Cherry Health Center, LLC 97 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Citizens Memorial Home Health Home health agency, Bolivar, MO, CCN 267196
• Citizens Memorial Hospice Hospice, Bolivar, MO, CCN 261508
• Citizens Memorial Hospital Hospital, Bolivar, MO, CCN 260195

Medicare fee-for-service enrollment

Enrolled in MO

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jul 9, 2007.

{
    "created_epoch": "1149292800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1932147808",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1240 N BUTTERFIELD RD",
            "city": "BOLIVAR",
            "state": "MO",
            "postal_code": "656133016",
            "telephone_number": "417-326-6021",
            "fax_number": "417-326-6347"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1240 N BUTTERFIELD RD",
            "city": "BOLIVAR",
            "state": "MO",
            "postal_code": "656133016",
            "telephone_number": "417-326-6021",
            "fax_number": "417-326-6347"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOGAN",
        "first_name": "MARY",
        "middle_name": "LYNN",
        "name_prefix": "Mrs.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-03",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MO",
            "license": "2005034573",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS NUMBER",
            "identifier": "209993",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Leann L Henenberg
• Tracy L Henry, SLP
• Julie Henson
• Jessica Hicks, AT
• Stephanie Higginbotham
• Mariah Elizabeth Hollabaugh, PHARMD
• Home Court Advantage V
• Home Court Advantage, Inc.
• Home Court Advantage, Inc.
• Home Court Advantage, Inc.

• All providers in Bolivar, MO
• Family Medicine Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.