Individual provider Active NPI

David A Borgman, MBA, MS, PT

  • Physical Therapist
  • Maumee, OH
National Provider Identifier
1013258912
Registry record updated Jun 5, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT004184 Issued in OH
Practice address
1560 Henthorne Dr
Maumee, OH 43537-1371
Phone
(419) 866-5196
Fax
(419) 866-5663
NPI assigned
Mar 4, 2013
Last updated
Jun 5, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 5, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT004184 OH Primary

Addresses

Primary practice location

1560 Henthorne Dr
Maumee, OH 43537-1371

Mailing address

1560 Henthorne Dr
Maumee, OH 43537-1371
Phone (419) 866-5196

Other identifiers 2

IdentifierTypeStateIssuer
1609899061OtherOHCOMPANY NPI
0392980MedicaidOH

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address dborgman@progsolutions.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Business Administration, Master of Science

State licenses

LicenseStateTypeSpecialty
PT004184OHMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Fairwood Chiropractic & Physical Therapy Physical Therapist Past Accepting new patients
Progressive Therapy Alternatives, Inc Physical Therapist Past Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1362355200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1685923200000",
    "number": "1013258912",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1560 HENTHORNE DR",
            "city": "MAUMEE",
            "state": "OH",
            "postal_code": "435371371",
            "telephone_number": "419-866-5196",
            "fax_number": "419-866-5663"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1560 HENTHORNE DR",
            "city": "MAUMEE",
            "state": "OH",
            "postal_code": "435371371",
            "telephone_number": "419-866-5196",
            "fax_number": "419-866-5663"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BORGMAN",
        "first_name": "DAVID",
        "middle_name": "A",
        "credential": "MBA, MS, PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-03-04",
        "last_updated": "2023-06-05",
        "certification_date": "2023-06-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "OH",
            "license": "PT004184",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "COMPANY NPI",
            "identifier": "1609899061",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0392980",
            "state": "OH"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "dborgman@progsolutions.com",
            "affiliation": "N",
            "endpointDescription": "company email address",
            "address_1": "1560 Henthorne Dr",
            "city": "Maumee",
            "state": "OH",
            "country_code": "US",
            "postal_code": "435371371",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Maumee, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 2023; 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.