Jean L Bohanan, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

006742L Issued in PA

Practice address

53 Gravel St
Wilkes Barre, PA 18705-3738

Phone

(570) 371-5600

NPI assigned

Aug 12, 2009

Last updated

Aug 23, 2023By the provider in NPPES

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Other names 1

• Jean L Fredmund Former name

Medicare fee-for-service enrollment

Enrolled in PA

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 1988

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Geisinger ClinicGroup PAC ID 5395657001, 3,432 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Geisinger Clinic

  • Family Medicine Physician
  • Danville, PA
  • NPI 1366493868
  Medicare reassignment Care Compare group NPD
• Geisinger Clinic

  • Surgery Physician
  • Danville, PA
  • NPI 1255382784
  NPD
• Geisinger Clinic

  • Diagnostic Radiology Physician
  • Danville, PA
  • NPI 1558313023
  NPD
• Pediatria Healthcare,LLC

  • Medically Fragile Infants and Children Day Care
  • Wilkes Barre, PA
  • NPI 1720214133
  NPD (past)
• Pediatriahealthcarellc

  • Medically Fragile Infants and Children Day Care
  • Wilkes Barre, PA
  • NPI 1639305048
  NPD (past)

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

{
    "created_epoch": "1250035200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692748800000",
    "number": "1831321736",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "427 DIVISION ST",
            "city": "MOUNTAIN TOP",
            "state": "PA",
            "postal_code": "187071154",
            "telephone_number": "570-899-6860"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "53 GRAVEL ST",
            "city": "WILKES BARRE",
            "state": "PA",
            "postal_code": "187053738",
            "telephone_number": "570-371-5600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOHANAN",
        "first_name": "JEAN",
        "middle_name": "L",
        "credential": "PT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-08-12",
        "last_updated": "2023-08-23",
        "certification_date": "2023-08-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "PA",
            "license": "006742L",
            "primary": true
        },
        {
            "code": "2251P0200X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Pediatrics",
            "state": "PA",
            "license": "PT006742L",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JEAN",
            "last_name": "FREDMUND",
            "middle_name": "L",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Nancy Jean Bodman-Goy, CRNP
• Norma Boechat, PA-C
• John Anthony Boger, M.D.
• Karenbeth Heikkinen Bohan, PHARM.D., BCPS
• Patrick John Bohan, RPH
• Kala Bokeko, PA-C
• Brian Eric Bolden, MD
• Kelly M Bolesta, PHARM.D.
• Joseph John Bolinsky III, PA-C
• Kavita S Bommasamudram, MD

• Physical Therapist in Wilkes Barre, PA
• Providers in Wilkes Barre, PA by specialty
• Physical Therapist in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.