Peter Shelby Bogard DO

Primary specialty

Sports Medicine (Family Medicine) PhysicianTaxonomy code 207QS0010X

License

DO18557 Issued in OR

Legal business name

PETER SHELBY BOGARD DO

Doing business as

Bogard Family and Sports Medicine

Practice address

700 SW Ramsey
Suite 104
Grants Pass, OR 97527-5788

Phone

(541) 471-4930

Fax

(541) 471-1331

NPI assigned

Feb 28, 2008

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Peter Shelby Bogard, D.O.

Title

Doctor

Phone

(541) 471-4930

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Bogard Family and Sports Medicine Doing business as

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Kimberly Bailey Noonan, FNP

  • Family Nurse Practitioner
  • Fort Mill, SC
  • NPI 1720035397
  NPD (past)

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

{
    "created_epoch": "1204156800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1205712000000",
    "number": "1003085630",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 SW RAMSEY",
            "address_2": "SUITE 104",
            "city": "GRANTS PASS",
            "state": "OR",
            "postal_code": "975275788",
            "telephone_number": "541-471-4930",
            "fax_number": "541-471-1331"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 SW RAMSEY",
            "address_2": "SUITE 104",
            "city": "GRANTS PASS",
            "state": "OR",
            "postal_code": "975275788",
            "telephone_number": "541-471-4930",
            "fax_number": "541-471-1331"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PETER SHELBY BOGARD DO",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-02-28",
        "last_updated": "2008-03-17",
        "status": "A",
        "authorized_official_last_name": "BOGARD",
        "authorized_official_first_name": "PETER",
        "authorized_official_middle_name": "SHELBY",
        "authorized_official_title_or_position": "DOCTOR",
        "authorized_official_telephone_number": "541-471-4930",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "207QS0010X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine, Sports Medicine",
            "state": "OR",
            "license": "DO18557",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "058748",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Bogard Family and Sports Medicine",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Eric Matthew Perry, M.D.
• Bradley Personius, MD
• Carol Michelle Personius, O.T.R./L
• Jordan Personius, PA
• Teresa M Persson, MS LPC
• Marla Peters, MD
• Katie Petersen, CPM, LDM
• Paula M Peterson, LMT
• Samuel Nolan Peterson, AU.D.
• Kimberly Petetit

• Sports Medicine (Family Medicine) Physician in Grants Pass, OR
• Providers in Grants Pass, OR by specialty
• Sports Medicine (Family Medicine) Physician in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2008; 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.