Oleg Bohomol, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT24983 Issued in FL

Practice address

410 Camelia TRL
St Augustine, FL 32086-5513

Phone

(904) 392-0057

NPI assigned

Aug 26, 2015

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• FM Medical Urgent Care, Inc.

  • Urgent Care Clinic/Center
  • St Augustine, FL
  • NPI 1053790246
  NPD

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

{
    "created_epoch": "1440547200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1440547200000",
    "number": "1700253770",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "410 CAMELIA TRL",
            "city": "ST AUGUSTINE",
            "state": "FL",
            "postal_code": "320865513",
            "telephone_number": "904-392-0057"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "410 CAMELIA TRL",
            "city": "ST AUGUSTINE",
            "state": "FL",
            "postal_code": "320865513",
            "telephone_number": "904-392-0057"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOHOMOL",
        "first_name": "OLEG",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-08-26",
        "last_updated": "2015-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "PT24983",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Natalie Boazman
• Anne Hill Boddy, D.P.T.
• Bodywise Studios, Inc.
• Jennifer Boegler
• Dominic Edward Boehnke
• Adrianna Zenia Bokalo, MED
• Josephine Luz Bokowski, LMHC, NCC, CBA
• Bold City Dermatology LLC
• Clarrissa Bolin
• Marisol Bolivar, DMD, MS

• Physical Therapist in St Augustine, FL
• Providers in St Augustine, FL by specialty
• Physical Therapist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.