Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Theodore Charles Wogan

Individual provider Student in an Organized Health Care Education/Training Program · NPI 1952015471

Theodore Charles Wogan is a Nurse Practitioner in Medford, Oregon. Qualified in 2022, 4 years ago. Practices with Southern Oregon Cardiology LLC, a 27-clinician group, accepts Medicare assignment and offers telehealth. Licensed in Oregon.

Years since qualifying
4
Licensed in
OR
In the registry since
2023
Specialties on file
2

Practice location Address checks out

2825 E Barnett Rd
Medford, OR 97504-8332
Phone: (541) 789-7000
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Nurse Practitioner (primary) Taxonomy 363LF0000X · Licence 10003883 (OR)
Student in an Organized Health Care Education/Training Program Taxonomy 390200000X

Record details

NPI number1952015471
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedJanuary 9, 2023
Last updated in NPPESFebruary 2, 2023
Certification dateFebruary 2, 2023
Mailing address24 Emerick St, Ashland, OR 97520-2066

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2022 (4 years in practice)
Group practice Southern Oregon Cardiology Llc — 27 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services

Other providers in Medford