Active NPI
Peter Allen Bogart, DC
- Chiropractor
- Waltham, MA
National Provider Identifier
1306827779
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 671
- Practice address
- 6 Bow St
Waltham, MA 02452-4807 - Phone
- (781) 891-9734
- Fax
- (781) 647-7940
- NPI assigned
- Nov 10, 2005
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 671 | MA | Primary |
Addresses
Primary practice location
6 Bow St
Waltham, MA 02452-4807
Mailing address
6 Bow St
Waltham, MA 02452-4807
Phone (781) 891-9734
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1601539 | Medicaid | MA |
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 671 | MA | MD | Chiropractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1131580800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1263513600000",
"number": "1306827779",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6 BOW ST",
"city": "WALTHAM",
"state": "MA",
"postal_code": "024524807",
"telephone_number": "781-891-9734",
"fax_number": "781-647-7940"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6 BOW ST",
"city": "WALTHAM",
"state": "MA",
"postal_code": "024524807",
"telephone_number": "781-891-9734",
"fax_number": "781-647-7940"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BOGART",
"first_name": "PETER",
"middle_name": "ALLEN",
"credential": "DC",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2005-11-10",
"last_updated": "2010-01-15",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "MA",
"license": "671",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1601539",
"state": "MA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Waltham, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.