Active NPI
Mary K Bogumill, PHD
- Clinical Neuropsychologist
- Helena, MT
National Provider Identifier
1295960003
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Neuropsychologist
- Practice address
- 2475 E Broadway St
Helena, MT 59601-4928 - Phone
- (406) 444-2288
- Fax
- (406) 444-2163
- NPI assigned
- May 22, 2009
- 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 |
|---|---|---|---|---|
| Clinical Neuropsychologist | 103G00000X | MT | Primary |
Addresses
Primary practice location
2475 E Broadway St
Helena, MT 59601-4928
Mailing address
2475 E Broadway St
Helena, MT 59601-4928
Phone (406) 444-2288
Other names 1
- Mary K Bogumill
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
- Credentials
- Doctor of Philosophy
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1242950400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1242950400000",
"number": "1295960003",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2475 E BROADWAY ST",
"city": "HELENA",
"state": "MT",
"postal_code": "596014928",
"telephone_number": "406-444-2288",
"fax_number": "406-444-2163"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2475 E BROADWAY ST",
"city": "HELENA",
"state": "MT",
"postal_code": "596014928",
"telephone_number": "406-444-2288",
"fax_number": "406-444-2163"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BOGUMILL",
"first_name": "MARY",
"middle_name": "K",
"credential": "PHD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2009-05-22",
"last_updated": "2009-05-22",
"status": "A"
},
"taxonomies": [
{
"code": "103G00000X",
"taxonomy_group": "",
"desc": "Clinical Neuropsychologist",
"state": "MT",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "MARY",
"last_name": "BOGUMILL",
"middle_name": "K",
"credential": "PHD",
"code": "2",
"type": "Professional Name"
}
]
}Other providers in Helena, MT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.