Beverly J Bohac, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

25128 Issued in WI

Practice address

707 Ash Street
Spooner, WI 54801-1903

Phone

(715) 635-2151

Fax

(715) 839-5176

NPI assigned

Jun 21, 2006

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

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1150848000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1498608000000",
    "number": "1477599074",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 19070",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543079070",
            "telephone_number": "920-496-4700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "707 ASH STREET",
            "city": "SPOONER",
            "state": "WI",
            "postal_code": "548011903",
            "telephone_number": "715-635-2151",
            "fax_number": "715-839-5176"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOHAC",
        "first_name": "BEVERLY",
        "middle_name": "J",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-21",
        "last_updated": "2017-06-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WI",
            "license": "25128",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30518600",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Adam James Barg, PT
• Holly Kay Barrett, APRN, CNP
• Megan R Bauer, SAC-IT
• Benedictine Living Community of Spooner
• Laura Lynne Boehlke-Bray, M.D.
• Sydnee Jolyn Borelli, COTA
• Bruce Edward Bray
• James Ballantine Brown Jr., MD
• Jill Renee Butkus, OTR/L
• Stephen John Carlson, M.D.

• Family Medicine Physician in Spooner, WI
• Providers in Spooner, WI by specialty
• Family Medicine Physician in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 2017; 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.