Mark William Bogert, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

ND 0534 Issued in ND

Practice address

602 Ash Ave
Glen Ullin, ND 58632-0065

Phone

(701) 348-9175

NPI assigned

Apr 3, 2008

Last updated

Apr 3, 2008By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Bogerosa Inc.

  • Physical Therapist
  • Glen Ullin, ND
  • NPI 1043289895
  Authorized official Same address or phone
• Intercept Youth Services, Inc

  • Addiction Psychiatry Physician
  • Roanoke, VA
  • NPI 1730608217
  NPD (past)

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

{
    "created_epoch": "1207180800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1207180800000",
    "number": "1235302878",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4729 AMBERGLOW DR",
            "city": "BISMARCK",
            "state": "ND",
            "postal_code": "585038846",
            "telephone_number": "701-426-7095",
            "fax_number": "701-250-0182"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "602 ASH AVE",
            "city": "GLEN ULLIN",
            "state": "ND",
            "postal_code": "586320065",
            "telephone_number": "701-348-9175"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOGERT",
        "first_name": "MARK",
        "middle_name": "WILLIAM",
        "credential": "PT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-04-03",
        "last_updated": "2008-04-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "ND",
            "license": "ND 0534",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS/BLUE SHIELD",
            "identifier": "25559",
            "state": "ND"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "54373",
            "state": "ND"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Twyla Jane Barth
• Bogerosa Inc.
• Cathy A Chavarria
• Amanda Dewees, CNA
• Linda Duppong, PA-C
• Sara Farrell, PT, DPT, CLT
• Lasheva M Gallant

• Physical Therapist in Glen Ullin, ND
• Providers in Glen Ullin, ND by specialty
• Physical Therapist in North Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 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.

Verify at the official NPI Registry.