Active NPI
Bradford K Bohman, MD
- Anesthesiology Physician
- Ogden, UT
National Provider Identifier
1326059403
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Anesthesiology Physician
- License
- 85-174080-1205
- Practice address
- 5475 S 500 E
Ogden, UT 84405-6905 - Phone
- (800) 880-3566
- Fax
- (801) 733-5872
- NPI assigned
- Aug 11, 2006
- 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 |
|---|---|---|---|---|
| Anesthesiology Physician | 207L00000X | 85-174080-1205 | UT | Primary |
Addresses
Primary practice location
5475 S 500 E
Ogden, UT 84405-6905
Mailing address
2829 E 6200 S
Ogden, UT 84403
Phone (801) 476-3084
Other identifiers 8
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 870458780B01 | Other | UT | EDUCATORS MUTUAL |
| 52175 | Other | UT | HEALTHY U |
| 68295 | Other | UT | PEHP |
| 2000026 | Other | UT | UNITED HEALTHCARE |
| PR00182 | Other | UT | MOLINA |
| 107005086102 | Other | UT | IHC |
| 219494 | Other | UT | ALTIUS |
| 5823 | Other | UT | DESERET MUTUAL |
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
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 85-174080-1205 | UT | MD | Anesthesiology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1155254400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1326059403",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2829 E 6200 S",
"city": "OGDEN",
"state": "UT",
"postal_code": "84403",
"telephone_number": "801-476-3084"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5475 S 500 E",
"city": "OGDEN",
"state": "UT",
"postal_code": "844056905",
"telephone_number": "800-880-3566",
"fax_number": "801-733-5872"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BOHMAN",
"first_name": "BRADFORD",
"middle_name": "K",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-08-11",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "207L00000X",
"taxonomy_group": "",
"desc": "Anesthesiology",
"state": "UT",
"license": "85-174080-1205",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "EDUCATORS MUTUAL",
"identifier": "870458780B01",
"state": "UT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HEALTHY U",
"identifier": "52175",
"state": "UT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PEHP",
"identifier": "68295",
"state": "UT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UNITED HEALTHCARE",
"identifier": "2000026",
"state": "UT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MOLINA",
"identifier": "PR00182",
"state": "UT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "IHC",
"identifier": "107005086102",
"state": "UT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ALTIUS",
"identifier": "219494",
"state": "UT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DESERET MUTUAL",
"identifier": "5823",
"state": "UT"
}
],
"endpoints": [],
"other_names": []
}Other providers in Ogden, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.