Carolyn Bogart, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

14602 Issued in WI

Practice address

7300 Washington Ave Ste B
Mount Pleasant, WI 53406-6525

Phone

(262) 321-6000

NPI assigned

Jul 24, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1563926400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661817600000",
    "number": "1164075552",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7300 WASHINGTON AVE STE B",
            "city": "MOUNT PLEASANT",
            "state": "WI",
            "postal_code": "534066525",
            "telephone_number": "262-321-6000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7300 WASHINGTON AVE STE B",
            "city": "MOUNT PLEASANT",
            "state": "WI",
            "postal_code": "534066525",
            "telephone_number": "262-321-6000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOGART",
        "first_name": "CAROLYN",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-07-24",
        "last_updated": "2022-08-30",
        "certification_date": "2022-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IL",
            "license": "070024731",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WI",
            "license": "14602",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100198658",
            "state": "WI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "cbogart197346@direct.edward.org",
            "affiliation": "N",
            "address_1": "1807 S Washington St",
            "city": "Naperville",
            "state": "IL",
            "country_code": "US",
            "postal_code": "605652446",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Shana Blackman, DPT
• Allison Marie Blonski, MD
• Daniel Blonsky, PHARMD
• Kristine Blumm
• Czaka Bogan
• David John Boho, OTR
• Caroline Daniela Bonilla, MASTER OF SCIENCE
• Nathan Boren
• Thomas P Bormes, MD
• Kelley Boster, MS

• Physical Therapist in Mount Pleasant, WI
• Providers in Mount Pleasant, WI by specialty
• Physical Therapist in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 2022; 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.