Active NPI
Jeremiah James Bogdonovich
- Case Manager/Care Coordinator
- Neillsville, WI
National Provider Identifier
1295196202
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Case Manager/Care Coordinator
- Practice address
- 517 Court St
Room 503
Neillsville, WI 54456-1971 - Phone
- (715) 743-5192
- Fax
- (715) 743-5209
- NPI assigned
- Mar 18, 2016
- 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 |
|---|---|---|---|---|
| Case Manager/Care Coordinator | 171M00000X | Primary |
Addresses
Primary practice location
517 Court St
Room 503
Neillsville, WI 54456-1971
Mailing address
517 Court St
Room 503
Neillsville, WI 54456-1971
Phone (715) 743-5192
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1458259200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1458259200000",
"number": "1295196202",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "517 COURT ST",
"address_2": "ROOM 503",
"city": "NEILLSVILLE",
"state": "WI",
"postal_code": "544561971",
"telephone_number": "715-743-5192",
"fax_number": "715-743-5209"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "517 COURT ST",
"address_2": "ROOM 503",
"city": "NEILLSVILLE",
"state": "WI",
"postal_code": "544561971",
"telephone_number": "715-743-5192",
"fax_number": "715-743-5209"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BOGDONOVICH",
"first_name": "JEREMIAH",
"middle_name": "JAMES",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2016-03-18",
"last_updated": "2016-03-18",
"status": "A"
},
"taxonomies": [
{
"code": "171M00000X",
"taxonomy_group": "",
"desc": "Case Manager/Care Coordinator",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Neillsville, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.