Gable Aaron Bogner, PT, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT61380656 Issued in WA

Practice address

625 9TH Ave Ste 220
Longview, WA 98632-2465

Phone

(360) 578-1188

Fax

(360) 578-6251

NPI assigned

Nov 29, 2022

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in WA

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Longview Physical and Sports Therapy Services PSGroup PAC ID 6305832668, 8 clinicians

Practice addresses (Care Compare)

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.

• Longview Physical and Sports Therapy Services PS

  • Physical Therapist
  • Longview, WA
  • NPI 1184835100
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1669680000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1669680000000",
    "number": "1760192900",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "625 9TH AVE STE 220",
            "city": "LONGVIEW",
            "state": "WA",
            "postal_code": "986322465",
            "telephone_number": "360-578-1188",
            "fax_number": "360-578-6251"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "625 9TH AVE STE 220",
            "city": "LONGVIEW",
            "state": "WA",
            "postal_code": "986322465",
            "telephone_number": "360-578-1188",
            "fax_number": "360-578-6251"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOGNER",
        "first_name": "GABLE",
        "middle_name": "AARON",
        "name_prefix": "Mr.",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-11-29",
        "last_updated": "2022-11-29",
        "certification_date": "2022-11-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WA",
            "license": null,
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WA",
            "license": "PT61380656",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Melanie Katherine Bobbs, MD
• Bruce Louis Bobek, D.O.
• Janey Bochart
• Lane Bodenhamer
• Destinee Boggs, R-AAC, CPC
• Bryan A Bohling, M.D.
• Avneet Bola
• Katy Bolar, RN
• Jeb Bolerjack, RN
• Maegan R. S. Bolin, LMHC, CDP

• All providers in Longview, WA
• Physical Therapist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 29, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.