Nicole M Bobay, MPT, WCS, CIMT, CSCS

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

05007516A Issued in IN

Practice address

10228 Dupont Circle Dr E Ste 100
Fort Wayne, IN 46825-1611

Phone

(260) 222-7401

Fax

(260) 209-5956

NPI assigned

Oct 2, 2006

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

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/21210/brand/1/csg/1/fhir/r4
• Direct secure messaging: nicole.bobay.1@21210.direct.athenahealth.com

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

{
    "created_epoch": "1159747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675209600000",
    "number": "1114010683",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 772437",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482772437",
            "telephone_number": "317-575-7304",
            "fax_number": "317-575-7333"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10228 DUPONT CIRCLE DR E STE 100",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468251611",
            "telephone_number": "260-222-7401",
            "fax_number": "260-209-5956"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3982 New Vision Dr",
            "address_purpose": "LOCATION",
            "city": "Fort Wayne",
            "state": "IN",
            "postal_code": "468451712",
            "country_code": "US",
            "telephone_number": "260-483-9933",
            "fax_number": "260-483-9931",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BOBAY",
        "first_name": "NICOLE",
        "middle_name": "M",
        "credential": "MPT, WCS, CIMT, CSCS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-02",
        "last_updated": "2023-02-01",
        "certification_date": "2023-02-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IN",
            "license": "05007516A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000208508",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• James Ervin Blume, O.D.
• Rebecca Marie Blume, PA-C
• Emanuel Lucian Boar, PT
• Bonnie Boatwright, LPN
• Lisa S Bobay, PA-C
• Jared Bobcean, MT-BC
• Eric James Bobilya, OT
• Lucian Dan Boboia, DDS
• Michelle Bock
• Danielle Boddie, RN

• Physical Therapist in Fort Wayne, IN
• Providers in Fort Wayne, IN by specialty
• Physical Therapist in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 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.