Chad A Bogdonovich, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

6174024 Issued in WI

Practice address

604B North Division St
Colby, WI 54421

Phone

(715) 223-4060

Fax

(715) 223-4032

NPI assigned

May 11, 2006

Last updated

Jul 1, 2010By the provider in NPPES

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 WI

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Sport & Spine Clinic LP

  • Rehabilitation Clinic/Center
  • Greenwood, WI
  • NPI 1497833966
  Medicare reassignment
• Sport & Spine Clinic LP

  • Physical Therapist
  • Auburndale, WI
  • NPI 1043252695
  NPD (past)

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

{
    "created_epoch": "1147305600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1277942400000",
    "number": "1063462828",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "604B NORTH DIVISION ST.",
            "city": "COLBY",
            "state": "WI",
            "postal_code": "54421",
            "telephone_number": "715-223-4060",
            "fax_number": "715-223-4032"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "604B NORTH DIVISION ST",
            "city": "COLBY",
            "state": "WI",
            "postal_code": "54421",
            "telephone_number": "715-223-4060",
            "fax_number": "715-223-4032"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOGDONOVICH",
        "first_name": "CHAD",
        "middle_name": "A",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-11",
        "last_updated": "2010-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WI",
            "license": "6174024",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Aegis Group Practice LLC
• Charles Lee Bauman, PT
• Amanda Lynn Beyer, B.S.N., R.N.
• Carlson Chiropractic Clinic LLC (Philip Carlson, D.C.)
• Philip John Carlson, D.C.
• Colby Fire Department (Colby Ambulance Service)
• Colby School District
• Glynda Rae Gosse, R.N.

• Physical Therapist in Colby, WI
• Providers in Colby, WI by specialty
• Physical Therapist in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.