Kevin Scott Bohlen, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

5601002341 Issued in MI

Practice address

724 W Franklin St
Jackson, MI 49201-2008

Phone

(517) 784-3100

Fax

(517) 784-3200

NPI assigned

Nov 5, 2009

Last updated

Nov 5, 2009By the provider in NPPES

Sex

Male

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

Enrolled in MI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kbohlen451658@direct.hfhs.org

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Wa Foote Memorial Hospital, Inc

  dba Henry Ford Allegiance Health

  • Emergency Medicine Physician
  • Jackson, MI
  • NPI 1265487722
  Medicare reassignment NPD
• Independent Emergency Physicians, P.C.

  • Emergency Medical Services (Emergency Medicine) Physician
  • Southfield, MI
  • NPI 1780791343
  Medicare reassignment
• Independent Observation Physicians PLLC

  • Emergency Medical Services (Emergency Medicine) Physician
  • Southfield, MI
  • NPI 1700119500
  Medicare reassignment
• W.a. Foote Memorial Hospital, Inc

  dba Henry Ford Allegiance Health

  • Physician Assistant
  • Jackson, MI
  • NPI 1538606348
  NPD

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

{
    "created_epoch": "1257379200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1257379200000",
    "number": "1568799930",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "724 W FRANKLIN ST",
            "city": "JACKSON",
            "state": "MI",
            "postal_code": "492012008",
            "telephone_number": "517-784-3100",
            "fax_number": "517-784-3200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "724 W FRANKLIN ST",
            "city": "JACKSON",
            "state": "MI",
            "postal_code": "492012008",
            "telephone_number": "517-784-3100",
            "fax_number": "517-784-3200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOHLEN",
        "first_name": "KEVIN",
        "middle_name": "SCOTT",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-11-05",
        "last_updated": "2009-11-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "MI",
            "license": "5601002341",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bobchi Inverciones L.L.C. (Tri-State Mobile Ultrasound)
• Nina Marie Bock, PA-C
• Aida Bodour, M.D.
• Jalen Kainick Bogan, M.A, LPC
• Kelli Lynn Bogue, AU.D.
• Amber Lyn Bohnett-Smith, MA, LLPC, NCC
• Bok Medical Service
• Amanda Joyce Bolanowski, LLMSW
• Kristina Bolante, PT
• Cheyenne Tayler Bolenbaugh, CTRS

• Medical Physician Assistant in Jackson, MI
• Providers in Jackson, MI by specialty
• Medical Physician Assistant in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2009; 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.