Abigail Bogner, PTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

40QB00403700 Issued in NJ

Practice address

30 W Maple Ave
Merchantville, NJ 08109-5104

Phone

(856) 661-0200

NPI assigned

Apr 19, 2023

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1681862400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1681862400000",
    "number": "1356038558",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14 PARKE PLACE BLVD STE D",
            "city": "SEWELL",
            "state": "NJ",
            "postal_code": "080802662",
            "telephone_number": "856-256-8393"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 W MAPLE AVE",
            "city": "MERCHANTVILLE",
            "state": "NJ",
            "postal_code": "081095104",
            "telephone_number": "856-661-0200"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "14 Parke Place Blvd Ste D",
            "address_purpose": "LOCATION",
            "city": "Sewell",
            "state": "NJ",
            "postal_code": "080802662",
            "country_code": "US",
            "telephone_number": "856-256-8393",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BOGNER",
        "first_name": "ABIGAIL",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-04-19",
        "last_updated": "2023-04-19",
        "certification_date": "2023-04-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "NJ",
            "license": "40QB00403700",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Madison Kate Adams, APN
• Assoc. of Maple Podiatry,PA
• Amybeth Levie Berner, MA, LPC, NBCC
• Michelle Bruno, CF-SLP
• Busy Bee Aac LLC
• Meghan Calavano
• Chris Chianese, MS, DC
• Lillee Chianese, DC

• Physical Therapy Assistant in Merchantville, NJ
• Providers in Merchantville, NJ by specialty
• Physical Therapy Assistant in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 19, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.