Active NPI
Donna M Bohannan, PT
- Physical Therapist
- Denver, CO
National Provider Identifier
1215918982
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 5152
- Practice address
- 4567 E 9TH Ave
Denver, CO 80220-3908 - Phone
- (303) 320-2818
- Fax
- (303) 320-7117
- NPI assigned
- Nov 9, 2005
- Sex
- Female
- 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 | 5152 | CO | Primary |
Addresses
Primary practice location
4567 E 9TH Ave
Denver, CO 80220-3908
Mailing address
4567 E 9TH Ave
Attn Rose Inpatient Rehab
Denver, CO 80220-3908
Phone (303) 320-2818
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 86723251 | Other | CO | MEDICAID PRACTICE GROUP # |
| 066615 | Other | CO | MEDICARE GROUP # |
| 50272357 | Medicaid | CO |
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 |
|---|---|---|---|
| 5152 | CO | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1131494400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1211328000000",
"number": "1215918982",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4567 E 9TH AVE",
"address_2": "ATTN ROSE INPATIENT REHAB",
"city": "DENVER",
"state": "CO",
"postal_code": "802203908",
"telephone_number": "303-320-2818",
"fax_number": "303-320-7117"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4567 E 9TH AVE",
"city": "DENVER",
"state": "CO",
"postal_code": "802203908",
"telephone_number": "303-320-2818",
"fax_number": "303-320-7117"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BOHANNAN",
"first_name": "DONNA",
"middle_name": "M",
"name_prefix": "Mrs.",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2005-11-09",
"last_updated": "2008-05-21",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "CO",
"license": "5152",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICAID PRACTICE GROUP #",
"identifier": "86723251",
"state": "CO"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE GROUP #",
"identifier": "066615",
"state": "CO"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "50272357",
"state": "CO"
}
],
"endpoints": [],
"other_names": []
}Other providers in Denver, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.