Amanda Bogle, PTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

3420 Issued in OK

Practice address

2103 S Main St
Elk City, OK 73644-9166

Phone

(580) 225-0075

NPI assigned

Jul 29, 2021

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": "1627516800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1627516800000",
    "number": "1881367381",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "440 MERCHANT DR",
            "city": "NORMAN",
            "state": "OK",
            "postal_code": "730696470",
            "telephone_number": "405-809-8713"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2103 S MAIN ST",
            "city": "ELK CITY",
            "state": "OK",
            "postal_code": "736449166",
            "telephone_number": "580-225-0075"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOGLE",
        "first_name": "AMANDA",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-07-29",
        "last_updated": "2021-07-29",
        "certification_date": "2021-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "OK",
            "license": "3420",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kelly Lynn Birdshead
• Nichole Marie Blackburn, FNP-C
• Blick Medical LLC
• Brian E Blick, MD
• Rachel Michelle Bliss, BS. CADC UNDER SUP.
• Jessica Lei Boone
• Dale A Boren Jr., PT, MPT
• Randi Dawn Boyer, B.S.W., BHRS, CM-A
• Charity Bradshaw
• Donna Marie Brinkley

• Physical Therapy Assistant in Elk City, OK
• Providers in Elk City, OK by specialty
• Physical Therapy Assistant in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2021; 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.