Active NPI
Holly Jean Bogazke, PTA
- Physical Therapy Assistant
- Omaha, NE
National Provider Identifier
1457596306
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- License
- 01134
- Practice address
- 11623 Arbor St
Omaha, NE 68144-2981 - Phone
- (800) 334-1919
- NPI assigned
- Dec 6, 2008
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Physical Therapy Assistant | 225200000X | 01134 | IA | Primary |
Addresses
Primary practice location
11623 Arbor St
Omaha, NE 68144-2981
Mailing address
602 S 4TH St
Eddyville, IA 52553-9618
Phone (641) 226-3998
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": "1228521600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1228521600000",
"number": "1457596306",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "602 S 4TH ST",
"city": "EDDYVILLE",
"state": "IA",
"postal_code": "525539618",
"telephone_number": "641-226-3998"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11623 ARBOR ST",
"city": "OMAHA",
"state": "NE",
"postal_code": "681442981",
"telephone_number": "800-334-1919"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BOGAZKE",
"first_name": "HOLLY",
"middle_name": "JEAN",
"credential": "PTA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-12-06",
"last_updated": "2008-12-06",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "IA",
"license": "01134",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Omaha, NE
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.