Kristina Nichole Bogar, D.O.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

061943 Issued in GA

Practice address

3450 Acworth Due West Rd
BLDG 200, Suite 220
Kennesaw, GA 30144-3335

Phone

(770) 456-5941

Fax

(770) 456-5942

NPI assigned

Jun 3, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in GA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy, Doctor of Medicine

State licenses

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

{
    "created_epoch": "1149292800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1579737600000",
    "number": "1497793186",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3450 ACWORTH DUE WEST RD",
            "address_2": "BLDG 200, SUITE 220",
            "city": "KENNESAW",
            "state": "GA",
            "postal_code": "301443335",
            "telephone_number": "770-456-5941",
            "fax_number": "770-456-5942"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3450 ACWORTH DUE WEST RD",
            "address_2": "BLDG 200, SUITE 220",
            "city": "KENNESAW",
            "state": "GA",
            "postal_code": "301443335",
            "telephone_number": "770-456-5941",
            "fax_number": "770-456-5942"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOGAR",
        "first_name": "KRISTINA",
        "middle_name": "NICHOLE",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-03",
        "last_updated": "2020-01-23",
        "certification_date": "2020-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "M0667",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "GA",
            "license": "061943",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "863007771D",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1795445",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Rebekah Leigh Bobo
• Carol S Boczarski, OTR/L
• Joseph W. Boecker, D.O.
• Morgan Boehn, M.ED. CCC-SLP
• Erwin Otto Boehringer, D.C.
• Leigh Anne Bohacek, MPT
• Abby Caudle Bohler, AU.D.
• Sarah B. Bolick, PA
• Jennifer Boner
• Laura Bonin, DPT

• Family Medicine Physician in Kennesaw, GA
• Providers in Kennesaw, GA by specialty
• Family Medicine Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.