Charles Mikell Bova, M.D.

Primary specialty

Pain Medicine (Physical Medicine & Rehabilitation) PhysicianTaxonomy code 2081P2900X

License

185699 Issued in UT

Practice address

3336 Pioneer Pkwy
Suite 204
West Valley City, UT 84120-2000

Phone

(801) 964-3249

NPI assigned

Dec 19, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

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

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.

• DHHS PHS Naihs Chinle Comprehensive Health Care Facility

  • General Acute Care Hospital
  • Chinle, AZ
  • NPI 1508800129

  TX

  Medicare reassignment NPD
• Spine and Sports Medicine Inc

  • Interventional Pain Medicine Physician
  • West Valley City, UT
  • NPI 1073677845
  NPD (past) Authorized official
• DHHS PHS Naihs Chinle Comprehensive

  • Ambulatory Surgical Clinic/Center
  • Chinle, AZ
  • NPI 1922253129
  NPD
• DHHS PHS Naihs Chinle Comprehensive Health Care Facility

  • General Acute Care Hospital
  • Pinon, AZ
  • NPI 1396761565
  NPD

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

{
    "created_epoch": "1166486400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1013071885",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3065 OAK RIM LN",
            "city": "PARK CITY",
            "state": "UT",
            "postal_code": "840606804",
            "telephone_number": "435-655-8648"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3336 PIONEER PKWY",
            "address_2": "SUITE 204",
            "city": "WEST VALLEY CITY",
            "state": "UT",
            "postal_code": "841202000",
            "telephone_number": "801-964-3249"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOVA",
        "first_name": "CHARLES",
        "middle_name": "MIKELL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-19",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2081P2900X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation, Pain Medicine",
            "state": "UT",
            "license": "185699",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Robyn E Boehmer, PAC
• Karen Bohn, PA-C
• Edgar Booth, MD
• Joseph Borshanian, NP
• Talmage Lee Bourne, MD
• Corinne Bowen
• Todd Alan Bowman Sr., D.M.D.
• Michael G Boyack, DDS
• Kelsey Bradley
• Staci Janae Brandenburg, PA-C

• Pain Medicine (Physical Medicine & Rehabilitation) Physician in West Valley City, UT
• Providers in West Valley City, UT by specialty
• Pain Medicine (Physical Medicine & Rehabilitation) Physician in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.