Shana L Bogert, LAT, ATC

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

License

RT007105 Issued in PA

Practice address

1680 Zion Rd
Bellefonte, PA 16823-9141

Phone

(252) 876-2776

NPI assigned

Mar 17, 2017

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": "1489708800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1543276800000",
    "number": "1801337282",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "638 RATTLESNAKE PIKE",
            "city": "JULIAN",
            "state": "PA",
            "postal_code": "168449010",
            "telephone_number": "252-876-2776"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1680 ZION RD",
            "city": "BELLEFONTE",
            "state": "PA",
            "postal_code": "168239141",
            "telephone_number": "252-876-2776"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "830 E Bishop St",
            "address_purpose": "LOCATION",
            "city": "Bellefonte",
            "state": "PA",
            "postal_code": "168232302",
            "country_code": "US",
            "telephone_number": "252-876-2776",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BOGERT",
        "first_name": "SHANA",
        "middle_name": "L",
        "name_prefix": "Mrs.",
        "credential": "LAT, ATC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-03-17",
        "last_updated": "2018-11-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "PA",
            "license": "RT007105",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Athletic Trainer in Bellefonte, PA
• Providers in Bellefonte, PA by specialty
• Athletic Trainer in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 27, 2018; 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.