Active NPI
Laura Davis Bogner, RPH
- Pharmacist
- Petoskey, MI
National Provider Identifier
1821370701
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 5302025051
- Practice address
- 710 Spring St
Petoskey, MI 49770-2851 - Phone
- (231) 348-5556
- Fax
- (231) 348-0826
- NPI assigned
- Sep 15, 2011
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 5302025051 | MI | Primary |
| Pharmacist | 183500000X | S018057 | AZ | |
| Pharmacist | 183500000X | 17907 | NV |
Addresses
Primary practice location
710 Spring St
Petoskey, MI 49770-2851
Mailing address
710 Spring St
Petoskey, MI 49770
Phone (231) 348-5556
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| S018057 | AZ | MD | Pharmacist |
| 5302025051 | MI | MD | Pharmacist |
| 17907 | NV | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1316044800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1316044800000",
"number": "1821370701",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "710 SPRING ST",
"city": "PETOSKEY",
"state": "MI",
"postal_code": "49770",
"telephone_number": "231-348-5556",
"fax_number": "231-348-0826"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "710 SPRING ST",
"city": "PETOSKEY",
"state": "MI",
"postal_code": "497702851",
"telephone_number": "231-348-5556",
"fax_number": "231-348-0826"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BOGNER",
"first_name": "LAURA",
"middle_name": "DAVIS",
"credential": "RPH",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2011-09-15",
"last_updated": "2011-09-15",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "MI",
"license": "5302025051",
"primary": true
},
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "AZ",
"license": "S018057",
"primary": false
},
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "NV",
"license": "17907",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Petoskey, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.