Active NPI
Camille Alison Quinn Boggs
- Physical Therapist
- Edmond, OK
National Provider Identifier
1235480658
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 2649
- Practice address
- 15308 Fairview Farm Rd
Edmond, OK 73013-1329 - Phone
- (405) 844-4808
- NPI assigned
- Sep 25, 2012
- Sex
- Female
- Sole proprietor
- Yes
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 | 2649 | OK | Primary |
Addresses
Primary practice location
15308 Fairview Farm Rd
Edmond, OK 73013-1329
Mailing address
15308 Fairview Farm Rd
Edmond, OK 73013-1329
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 |
|---|---|---|---|
| 2649 | OK | MD | Chiropractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1348531200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1348531200000",
"number": "1235480658",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "15308 FAIRVIEW FARM RD",
"city": "EDMOND",
"state": "OK",
"postal_code": "730131329"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "15308 FAIRVIEW FARM RD",
"city": "EDMOND",
"state": "OK",
"postal_code": "730131329",
"telephone_number": "405-844-4808"
}
],
"practiceLocations": [],
"basic": {
"last_name": "QUINN BOGGS",
"first_name": "CAMILLE",
"middle_name": "ALISON",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2012-09-25",
"last_updated": "2012-09-25",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "OK",
"license": "2649",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Edmond, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.