Emily Carol Bohannan, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PTL.0015443 Issued in CO

Practice address

8630 164TH Ave NE Ste 203
Redmond, WA 98052-1906

Phone

(425) 658-4980

NPI assigned

Mar 22, 2018

Sex

Female

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Innova Physical Therapy LLC

  • Physical Therapist
  • Redmond, WA
  • NPI 1497154504
  NPD

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

{
    "created_epoch": "1521676800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705622400000",
    "number": "1043714132",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8630 164TH AVE NE STE 203",
            "city": "REDMOND",
            "state": "WA",
            "postal_code": "980521906",
            "telephone_number": "425-658-4980"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8630 164TH AVE NE STE 203",
            "city": "REDMOND",
            "state": "WA",
            "postal_code": "980521906",
            "telephone_number": "425-658-4980"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3355 S Wadsworth Blvd",
            "address_purpose": "LOCATION",
            "city": "Lakewood",
            "state": "CO",
            "postal_code": "802275140",
            "country_code": "US",
            "telephone_number": "303-980-6762",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BOHANNAN",
        "first_name": "EMILY",
        "middle_name": "CAROL",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-03-22",
        "last_updated": "2024-01-19",
        "certification_date": "2024-01-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CO",
            "license": "PTL.0015443",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gregory J Blocki, OTD
• S. Katherine Bloomer, M.D.
• Kayla Marie Bocek
• Rosilda Ramos Boff, MHCA.MC.
• Kimberly Boggs
• Chris Boicelli
• Annette Bojang, RC, NA, AAC
• Kebba MB Bojang, MHT, RC
• Richard Kevin Bonilla
• Jennifer Claire Bonk-Brown

• Physical Therapist in Redmond, WA
• Providers in Redmond, WA by specialty
• Physical Therapist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 2024; 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.