Individual provider Active NPI

Bogan Frahm, DPT

  • Physical Therapist
  • Cornelius, NC
National Provider Identifier
1255182879
Registry record updated Apr 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
P22307 Issued in NC
Practice address
19607 W Catawba Ave Ste 102
Cornelius, NC 28031-4042
Phone
(704) 625-6191
NPI assigned
Apr 1, 2024
Last updated
Apr 1, 2024By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 1, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X P22307 NC Primary

Addresses

Primary practice location

19607 W Catawba Ave Ste 102
Cornelius, NC 28031-4042

Mailing address

20321 Sterling Bay LN W Apt B
Cornelius, NC 28031-4947
Phone (208) 640-3248

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240513002345 NC Practitioner - Physical Therapist in Private Practice 3173964889 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ascanio Physical TherapyGroup PAC ID 7416358767, 3 clinicians

Practice addresses (Care Compare)

19607 W Catawba Ave
Suite 102
Cornelius, NC 28031-4042
Phone (704) 625-6191

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Nutrition Healthworks LLC CurrentSince Apr 1, 2024 Accepting new patients
Ascanio Physical Therapy CurrentSince Apr 1, 2024 Accepting new patients

Locations

19607 W Catawba Ave
Ste 102
Cornelius, NC 28031
Phone (704) 625-6191

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1711929600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1711929600000",
    "number": "1255182879",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20321 STERLING BAY LN W APT B",
            "city": "CORNELIUS",
            "state": "NC",
            "postal_code": "280314947",
            "telephone_number": "208-640-3248"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19607 W CATAWBA AVE STE 102",
            "city": "CORNELIUS",
            "state": "NC",
            "postal_code": "280314042",
            "telephone_number": "704-625-6191"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FRAHM",
        "first_name": "BOGAN",
        "name_prefix": "Dr.",
        "credential": "DPT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-04-01",
        "last_updated": "2024-04-01",
        "certification_date": "2024-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NC",
            "license": "P22307",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cornelius, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.