Blayne Allyssa Bogard

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

299540 Issued in KY

Practice address

3235 Olivet Church Rd Ste D
Paducah, KY 42001-9545

Phone

(270) 443-5712

Fax

(270) 933-1095

NPI assigned

Jun 19, 2025

Last updated

Jun 19, 2025By the provider in NPPES

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

State licenses

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

{
    "created_epoch": "1750291200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750291200000",
    "number": "1790672194",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3235 OLIVET CHURCH RD STE D",
            "city": "PADUCAH",
            "state": "KY",
            "postal_code": "420019545",
            "telephone_number": "270-443-5712",
            "fax_number": "270-933-1095"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3235 OLIVET CHURCH RD STE D",
            "city": "PADUCAH",
            "state": "KY",
            "postal_code": "420019545",
            "telephone_number": "270-443-5712",
            "fax_number": "270-933-1095"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOGARD",
        "first_name": "BLAYNE",
        "middle_name": "ALLYSSA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-06-19",
        "last_updated": "2025-06-19",
        "certification_date": "2025-06-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "KY",
            "license": "299540",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kenny L Boaz
• Andre' Tyrone Bobo, M.D.
• Elizabeth Ann Bobo
• Brian R. Bodnarchuk, MD
• Gary Bodnarchuk, M.D.
• Sarah Bogard
• Kevin Lee Boggess, LCSW
• Anthony L Bohannon, PT
• Michelle Bohanon, RPH, BCPS
• Bohle Family Dentistry, PSC

• Speech-Language Pathologist in Paducah, KY
• Providers in Paducah, KY by specialty
• Speech-Language Pathologist in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 2025; 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.