DR. JOHN MICHAEL HOOG (NPI# 1255411385) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1255411385 |
| Entity Type | Individual |
| Full Name | DR. JOHN MICHAEL HOOG |
| Credential | M.D. |
| Practice Address |
2121 Lake Ave Fort Wayne IN 46805-5100 |
| Mailing Address |
2214 Forest Park Blvd Fort Wayne IN 46805-4528 |
| Practice Telephone | 2604265431 |
| Mailing Telephone | 2604846957 |
| Mailing Fax Number | 2604224000 |
| Enumeration Date | 2006-10-16 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2088P0231X |
Urology Specialization: Pediatric Urology |
01020454A | IN | Allopathic & Osteopathic Physicians |
| Street Address |
2121 LAKE AVE |
| City | FORT WAYNE |
| State | IN |
| Zip Code | 46805-5100 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124021100 | Karen F Sloane | Podiatrist | 2121 Lake Ave, Fort Wayne, IN 46805-5100 | 2005-05-24 |
| 1346848348 | Jodi Lyn Van Veld | Occupational Therapist | 2121 Lake Ave, Fort Wayne, IN 46805-5100 | 2020-10-12 |
| 1346854213 | Amy Solaro | Social Worker | 2121 Lake Ave, Fort Wayne, IN 46805-5100 | 2020-09-08 |
| 1144831116 | Ann Marie Brunner | Pharmacist | 2121 Lake Ave, Fort Wayne, IN 46805-5100 | 2020-08-13 |
| 1871104042 | Lynne Koch | Pharmacist | 2121 Lake Ave, Fort Wayne, IN 46805-5100 | 2020-08-12 |
| 1790396950 | Joseph Amin Samy | Pharmacist | 2121 Lake Ave, Fort Wayne, IN 46805-5100 | 2020-08-12 |
| 1144831678 | Youlijan Samy | Pharmacist | 2121 Lake Ave, Fort Wayne, IN 46805-5100 | 2020-08-10 |
| 1881204139 | Lawrence Ejiofo | Pharmacist | 2121 Lake Ave, Fort Wayne, IN 46805-5100 | 2020-08-03 |
| 1821606575 | Nazret Tecle | Optometrist | 2121 Lake Ave, Fort Wayne, IN 46805-5100 | 2020-07-20 |
| 1689291619 | Adam Kreiger | Pharmacist | 2121 Lake Ave, Fort Wayne, IN 46805-5100 | 2020-06-25 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619589546 | Connor Gemlick | Student in an Organized Health Care Education/Training Program | 1918 Carew St., Fort Wayne, IN 46805 | 2020-08-21 |
| 1710464086 | S.t.a.r. Care Services | Clinic/Center | 3521 Lake Avenue, Suite #4, Fort Wayne, IN 46805 | 2018-07-19 |
| 1083122865 | Noel Shafi | Counselor | 3010 East State Boulevard, Fort Wayne, IN 46805 | 2018-01-16 |
| 1063963627 | Toni L Irby | Specialist | 3219 E State Blvd, Fort Wayne, IN 46805 | 2016-10-19 |
| 1639626211 | Logan Schwerer | Pharmacist | 923 Northcrest Business Center 6d, Fort Wayne, IN 46805 | 2016-09-01 |
| 1063817104 | Michale Diane Rothgeb | Physical Therapy Assistant | 2200 Randollia Dr, Fort Wayne, IN 46805 | 2014-10-31 |
| 1124435789 | Julia I. Mcfann | Physical Therapist | 2200 Randalia Dr, Fort Wayne, IN 46805 | 2014-07-16 |
| 1083036974 | Capital Senior Living Properties 4, Inc. | Assisted Living Facility | 3320 East State Boulevard, Fort Wayne, IN 46805 | 2014-01-10 |
| 1356772396 | Alexander James Medical Supply | Durable Medical Equipment & Medical Supplies | 2200 Lake Avenue, Suite 290, Fort Wayne, IN 46805 | 2013-12-02 |
| 1043595689 | Randy James Jennings | Pharmacist | 923 Northcrest Business Center, 6-d, Fort Wayne, IN 46805 | 2011-10-14 |
| Find all providers in zip 46805 | ||||
| Taxonomy Code | 2088P0231X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Urology |
| Specialization | Pediatric Urology |
| Surgeons who can diagnose, treat, and manage children’s urinary and genital problems. A pediatric urologist devotes a minimum of 50% of his or her practice to the urologic problems of infants, children, and adolescents. Pediatric urologists generally provide the following services: the evaluation and management of voiding disorders; vesicoureteral reflux, and urinary tract infections that require surgery; surgical reconstruction of the urinary tract (kidneys, ureters, and bladder) including genital abnormalities, hypospadias, and intersex conditions; surgery for groin conditions in childhood and adolescence (undescended testes, hydrocele/hernia, varicocele). |
| Notes: Source: American Academy of Pediatrics [7/1/2006: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881896876 | Lawrence Edward Allen | Urology | 854 Ashbrooke Ct, Anderson, IN 46012-9248 | 2007-06-03 |
| 1336366806 | Ethan I. Franke | Urology | 702 Barnhill Dr, Suite 246, Indianapolis, IN 46202-5128 | 2007-04-19 |
| 1508913328 | Benjamin Whittam | Urology | 705 Riley Hospital Drive, Ste 4230, Indianapolis, IN 46202 | 2007-01-04 |
| 1619051521 | Richard T. Senn, Md, Inc. | Urology | 113 W Southway Blvd, Kokomo, IN 46902-3653 | 2006-10-25 |
| 1740276880 | Martin Kaefer | Urology | 702 Barnhill Dr, Ste 4230, Indianapolis, IN 46202-5128 | 2005-09-23 |
| City | FORT WAYNE |
| Zip Code | 46805 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.