Kevin John Bohman, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

8579941-2401 Issued in UT

Practice address

670 E 3900 S Ste 210
Salt Lake City, UT 84107-1981

Phone

(801) 266-3979

Fax

(801) 270-8587

NPI assigned

Sep 10, 2013

Reactivated

Sep 12, 2023

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

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.

• Ddi Vantage

  • Developmentally Disabled Services Day Training Agency
  • Salt Lake City, UT
  • NPI 1346344454
  NPD (past)

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

{
    "created_epoch": "1378771200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694995200000",
    "number": "1770918666",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "165 S MAIN ST",
            "city": "TOOELE",
            "state": "UT",
            "postal_code": "840742127",
            "telephone_number": "435-833-0725",
            "fax_number": "435-882-2768"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "670 E 3900 S STE 210",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841071981",
            "telephone_number": "801-266-3979",
            "fax_number": "801-270-8587"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOHMAN",
        "first_name": "KEVIN",
        "middle_name": "JOHN",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-09-10",
        "last_updated": "2023-09-18",
        "certification_date": "2023-09-18",
        "deactivation_date": "2022-04-12",
        "reactivation_date": "2023-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "UT",
            "license": "8579941-2401",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Olivia Milise Bogle, PT, DPT
• Lindsay T Bognar, PT, DPT
• William J Bogus, O.D.
• Mary Elizabeth Bohan
• Mary K Bohlscheid
• Isabella Rae Bohn
• Jerry Lee Bohnet
• Susan A. Bohning, CCC-A
• John F. Bohnsack
• Margarita Bojorquez

• Physical Therapist in Salt Lake City, UT
• Providers in Salt Lake City, UT by specialty
• Physical Therapist in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2023; 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.