Mary A Hogan (NPI# 1376602136, PAC ID# 1759274392) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is PHYSICAL THERAPY.
| Nation Provider ID (NPI) | 1376602136 |
| PAC ID by PECOS | 1759274392 |
| Professional Enrollment ID | I20040206000049 |
| Full Name | Mary A Hogan |
| Address |
21 E Maple St D Hailey ID 83333-4900 |
| Gender | F |
| Credential | PT |
| Graduation Year | 1989 |
| Primary Specialty | PHYSICAL THERAPY |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 131323 | ST LUKE'S WOOD RIVER MEDICAL CENTER |
| Address | Phone | Organization |
|---|---|---|
| 21 E Maple St D, Hailey, ID 83333-4900 |
| Street Address |
21 E MAPLE ST D |
| City | HAILEY |
| State | ID |
| Zip | 83333-4900 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Carol A Wade | Nurse Practitioner | St Lukes Clinic - Wood River LLC | 21 E Maple St, Suite A, Hailey, ID 83333-4900 |
| Laira L Thomas | Nurse Practitioner | St Lukes Clinic - Wood River LLC | 21 E Maple St, Suite A, Hailey, ID 83333-4900 |
| Donald M Levin | Family Medicine | St Lukes Clinic - Wood River LLC | 21 E Maple St, Suite A, Hailey, ID 83333-4900 |
| Heather M Nope | Physician Assistant | Alliance Family Services Inc | 141 Citation Way, Suite 5, Hailey, ID 83333-5104 |
| Karen M Martinat | Clinical Social Worker | Alliance Family Services Inc | 141 Citation Way, Suite 5, Hailey, ID 83333-5104 |
| Derek A Schildknecht | Physical Therapy | 1014 Business Park Dr A, Hailey, ID 83333-5233 | |
| Kimberly A Mazik | Physical Therapy | Hailey Sport and Spine Physical Therapy Pa | 1014 Business Park Dr A, Hailey, ID 83333-5233 |
| Cheryl S Lenhart | Physical Therapy | Hailey Sport and Spine Physical Therapy Pa | 1014 Business Park Dr A, Hailey, ID 83333-5233 |
| David Bernard Verst | Orthopedic Surgery | 15 W Galena St, Hailey, ID 83333-8414 | |
| Kimberly Anne Hayes | Clinical Social Worker | 409 N Main St, Hailey, ID 83333-8416 | |
| Find all physicians in zip 83333 | |||
| City | HAILEY |
| Zip Code | 83333 |
| Specialty | PHYSICAL THERAPY |
| City + Specialty | HAILEY + PHYSICAL THERAPY |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.