Active NPI
Jason Bohl
- Physical Therapist
- Midland, MI
National Provider Identifier
1215770748
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 5501303189
- Practice address
- 4401 Campus Ridge Dr
Midland, MI 48640-6112 - Phone
- (989) 837-9100
- NPI assigned
- Jun 13, 2024
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 5501303189 | MI | Primary |
Addresses
Primary practice location
4401 Campus Ridge Dr
Midland, MI 48640-6112
Mailing address
4401 Campus Ridge Dr Ste 1000
Midland, MI 48640-6125
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5501303189 | MI | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1718236800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1724371200000",
"number": "1215770748",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4401 CAMPUS RIDGE DR STE 1000",
"city": "MIDLAND",
"state": "MI",
"postal_code": "486406125"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4401 CAMPUS RIDGE DR",
"city": "MIDLAND",
"state": "MI",
"postal_code": "486406112",
"telephone_number": "989-837-9100"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BOHL",
"first_name": "JASON",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2024-06-13",
"last_updated": "2024-08-23",
"certification_date": "2024-08-23",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "MI",
"license": "5501303189",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Midland, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 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.