Individual provider Active NPI

Joanell A Bohmert, PT

  • Physical Therapist
  • Mahtomedi, MN
National Provider Identifier
1114282068
Registry record updated Aug 31, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
1825 Issued in MN
Practice address
688 Wildwood Rd
Mahtomedi, MN 55115-1812
Phone
(651) 429-9947
Fax
(651) 429-1029
NPI assigned
Jul 6, 2012
Last updated
Aug 31, 2017By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 31, 2017

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 1825 MN Primary

Addresses

Primary practice location

688 Wildwood Rd
Mahtomedi, MN 55115-1812

Mailing address

199 Puma LN
Mahtomedi, MN 55115-6833
Phone (651) 270-9940

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

State licenses

LicenseStateTypeSpecialty
1825MNMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Fitness Focus, Inc. Physical Therapist PastSince Sep 1, 2011 Accepting new patients

Organizations & group practices 1

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": "1341532800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1504137600000",
    "number": "1114282068",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "199 PUMA LN",
            "city": "MAHTOMEDI",
            "state": "MN",
            "postal_code": "551156833",
            "telephone_number": "651-270-9940"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "688 WILDWOOD RD",
            "city": "MAHTOMEDI",
            "state": "MN",
            "postal_code": "551151812",
            "telephone_number": "651-429-9947",
            "fax_number": "651-429-1029"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOHMERT",
        "first_name": "JOANELL",
        "middle_name": "A",
        "credential": "PT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-07-06",
        "last_updated": "2017-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MN",
            "license": "1825",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mahtomedi, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2017; 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.