Individual provider Active NPI

Yoohee Kwon Bogan, DPT

  • Physical Therapist
  • Catonsville, MD
National Provider Identifier
1629616644
Registry record updated Jan 4, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
27794 Issued in MD
Practice address
836 N Rolling Rd
Catonsville, MD 21228-4136
Phone
(443) 514-0560
Fax
(410) 788-8590
NPI assigned
Dec 20, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 4, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 27794 MD Primary

Addresses

Primary practice location

836 N Rolling Rd
Catonsville, MD 21228-4136

Mailing address

790 Remington Blvd
Bolingbrook, IL 60440-4909
Phone (630) 296-2222

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD, DC2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20200117002105 MD Practitioner - Physical Therapist in Private Practice 7315372414 Reassigns benefits to 4 organizations
I20200121001705 DC Practitioner - Physical Therapist in Private Practice 7315372414 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
27794MDMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Healthpro Heritage Rehab & Fitness, LLC Physical Therapist CurrentSince Aug 30, 2023 Accepting new patients
Ati Holdings, LLC Physical Therapist CurrentSince Dec 1, 2019 Accepting new patients
Fox Rehab PT MD LLC Physical Therapist CurrentSince Jan 1, 2023 Accepting new patients
Healthpro Heritage Rehab & Fitness, LLC Physical Therapist CurrentSince Aug 30, 2023 Accepting new patients
Ati Holdings, LLC Physical Therapist CurrentSince Dec 1, 2019 Accepting new patients

Locations

790 Remington Blvd
Bolingbrook, IL 60440

4947 Paysphere Cir
Chicago, IL 60674
Phone (630) 783-2001

836 N Rolling Rd
Catonsville, MD 21228
Phone (443) 514-0560

4740 Cherry Hill Rd
College Park, MD 20740
Phone (240) 965-0999

1510 Rock Spring Rd
Ste C
Forest Hill, MD 21050
Phone (410) 420-3619

100 Brightwood Club Dr
Lutherville, MD 21093
Phone (410) 729-6552

52 Rising Sun Town Ctr
Rising Sun, MD 21911
Phone (410) 658-0100

11271 New Hampshire Ave
Silver Spring, MD 20904
Phone (240) 485-1280

2525 Pot Spring Rd
Timonium, MD 21093
Phone (410) 308-9702

11665 Doolittle Dr
Waldorf, MD 20602
Phone (301) 638-4100

Organizations & group practices 5

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

NPI Registry JSON

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

{
    "created_epoch": "1576800000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1672790400000",
    "number": "1629616644",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "790 REMINGTON BLVD",
            "city": "BOLINGBROOK",
            "state": "IL",
            "postal_code": "604404909",
            "telephone_number": "630-296-2222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "836 N ROLLING RD",
            "city": "CATONSVILLE",
            "state": "MD",
            "postal_code": "212284136",
            "telephone_number": "443-514-0560",
            "fax_number": "410-788-8590"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOGAN",
        "first_name": "YOOHEE",
        "middle_name": "KWON",
        "credential": "DPT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-12-20",
        "last_updated": "2023-01-04",
        "certification_date": "2023-01-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MD",
            "license": "27794",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Catonsville, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.