Peter Bogard, D.O.

Primary specialty

Sports Medicine (Family Medicine) PhysicianTaxonomy code 207QS0010X

License

DO18557 Issued in OR

Practice address

700 Ramsey Ave
Ste 104
Grants Pass, OR 97527-5788

Phone

(541) 471-4930

Fax

(541) 471-1331

NPI assigned

May 24, 2005

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

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. Confirm with the OIG exclusions search.

Credentials

Doctor of Osteopathy

Practice roles

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.

• Rogue River Family Practice Clinic PC

  • Family Medicine Physician
  • Rogue River, OR
  • NPI 1477613529
  NPD (past)

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

{
    "created_epoch": "1116892800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1205712000000",
    "number": "1659374528",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 RAMSEY AVE",
            "address_2": "STE 104",
            "city": "GRANTS PASS",
            "state": "OR",
            "postal_code": "975275788",
            "telephone_number": "541-471-4930",
            "fax_number": "541-471-1331"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 RAMSEY AVE",
            "address_2": "STE 104",
            "city": "GRANTS PASS",
            "state": "OR",
            "postal_code": "975275788",
            "telephone_number": "541-471-4930",
            "fax_number": "541-471-1331"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOGARD",
        "first_name": "PETER",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-05-24",
        "last_updated": "2008-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QS0010X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Sports Medicine",
            "state": "OR",
            "license": "DO18557",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "058748",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Bluehare LLC
• Anna Boak
• Jeanna Bobo
• Sheila Lynn Bodle
• Alexander Bogard
• Gagan Bohara, M.D.
• Zoey Boisen
• Susan Luques Boldt, M.S.
• Nikki Marie Boles, LMT
• Kayla Rose Bomben, DPT

• Sports Medicine (Family Medicine) Physician in Grants Pass, OR
• Providers in Grants Pass, OR by specialty
• Sports Medicine (Family Medicine) Physician in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; OIG LEIE.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.