Jamison Wade Bohl, M.D.
Individual provider Active NPI Family Medicine Physician · Johnstown, CO
NPI 1508849282 · NPPES record last updated Jun 11, 2021
Key facts
- NPI
- 1508849282
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- 51010 (CO)
- Practice address
- 4901 Thompson Pkwy
Johnstown, CO 80534-6426 - Phone
- (303) 338-4545
- NPI assigned
- Nov 28, 2005
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Medicare Care Compare profile
- Specialty
- Family Practice
- Education
- Loma Linda University School of Medicine, 2002
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Colorado Permanente Medical Group PC
Practice addresses (Care Compare)
1375 E 20TH Ave
Kaiser Permanente Skyline Medical Offices
Denver, CO 80205-5422
Phone (303) 338-4545
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CO
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20120830000445 | CO | Practitioner - Family Practice | 6002063823 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| A86826 | CA | MD | Family Medicine Physician |
| 51010 | CO | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Colorado Permanente Medical Group, P.C. | Current |
Accepting new patients |
Locations
1375 E 20th Ave
Ofc
Denver, CO 80205
10350 E Dakota Ave
Denver, CO 80247
Phone (303) 636-3350
2345 Bent Way
Longmont, CO 80503
Phone (303) 678-3275
4901 Thompson Pkwy
Loveland, CO 80534
Phone (970) 613-2320
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | A86826 | CA | |
| Family Medicine Physician | 207Q00000X | 51010 | CO | Yes |
Addresses
Primary practice location
4901 Thompson Pkwy
Johnstown, CO 80534-6426
Mailing address
10350 E Dakota Ave
Denver, CO 80247-1314
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 022682 | Other | CO | KAISER COMMERCIAL NUMBER |
| 28028872 | Medicaid | CO |
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| SOAP URL | https://careepiceast.kp.org:14430/Interconnect-prodcom/wcf/epic.community.hie/xcpdrespondinggateways | Health Information Exchange (HIE) |
Other providers in Johnstown, CO
- Kanchan Bhowmik
- Rebecca Marie Bierden
- Bilingual Neuropsychological Services
- Madelyn Black
- Stephanie Blackwell
- Gregory David Bond
- Casey Steven Bowling
- Breaking Point Therapy LLC
- Annalee Sheree Brooks
- Cara E. Brown
All providers in Johnstown, CO · Family Medicine Physician in Colorado
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 11, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.