Kerry Bohan

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

Practice address

255 Executive Dr Ste Ll105
Plainview, NY 11803-1718

Phone

(516) 576-2040

NPI assigned

Jan 1, 2022

Sex

Female

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)

Not enrolled

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

{
    "created_epoch": "1640995200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1640995200000",
    "number": "1780345876",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "120 OLD SOUTH PLANK RD",
            "city": "NEWBURGH",
            "state": "NY",
            "postal_code": "125502631",
            "telephone_number": "845-728-6522"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "255 EXECUTIVE DR STE LL105",
            "city": "PLAINVIEW",
            "state": "NY",
            "postal_code": "118031718",
            "telephone_number": "516-576-2040"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOHAN",
        "first_name": "KERRY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-01-01",
        "last_updated": "2022-01-01",
        "certification_date": "2021-12-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Robert T Bleck, PH.D.
• Seth Matthew Blum, DDS
• Mara Bochman, RN
• Rachel Bodh
• Dennis Bogovic, RPH
• Kelly Ann Boiko, MSED
• Marissa Bonasia-Solis, CCC-SLP
• Sara Bondar
• Mary J. Borcherding, M.A., CCC-SLP, TSSLD
• Diana Catherine Borowski, LMSW

• Athletic Trainer in Plainview, NY
• Providers in Plainview, NY by specialty
• Athletic Trainer in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 1, 2022; 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.