Shannon Bogle, PT

Primary specialty

Orthopedic Physical TherapistTaxonomy code 2251X0800X

License

PT12643 Issued in FL

Practice address

2106 S Lois Ave
Tampa, FL 33629-5659

Phone

(813) 287-9370

NPI assigned

Aug 30, 2006

Last updated

Dec 13, 2010By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

University of Florida College of Medicine, 1995

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Orthopedic Specialists, LLPGroup PAC ID 2466446992, 10 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Networks

• Optimum HealthCare HMO Network

Interoperability endpoints

• Direct secure messaging: shannon.bogle.1@18802.direct.athenahealth.com

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.

• Orthopedic Specialists, LLP

  dba Orthopedic Specialists

  • Orthopaedic Surgery Physician
  • Palm Harbor, FL
  • NPI 1588702450
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1156896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1292198400000",
    "number": "1851401582",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13020 N TELECOM PKWY",
            "city": "TEMPLE TERRACE",
            "state": "FL",
            "postal_code": "336370925"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2106 S LOIS AVE",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336295659",
            "telephone_number": "813-287-9370"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOGLE",
        "first_name": "SHANNON",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-30",
        "last_updated": "2010-12-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "FL",
            "license": "PT12643",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00465914",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Shelley E. Boggan, LCSW
• Raul R. Boggio, M. D.
• Christina Danielle Boggs, PH.D.
• Maureen Elizabeth Boggs, MSW
• Triana Monez Boggs, APRN, CNM
• Bryan Bognar, MD
• Jeff Bogner
• Christie Williams Bohling, PT, DPT, ATC
• Alaina Bohn
• Courtney Quinn Bohn, M.S. CCC-SLP

• Orthopedic Physical Therapist in Tampa, FL
• Providers in Tampa, FL by specialty
• Orthopedic Physical Therapist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 2010; 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.