Active NPI
Kirk-John Bogle
- Physical Therapy Assistant
- Salisbury, MD
National Provider Identifier
1881957884
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- License
- A3159
- Practice address
- 100 E Carroll St
St 3
Salisbury, MD 21801-5422 - Phone
- (410) 546-6400
- NPI assigned
- Jun 25, 2012
- Last updated
- Jun 25, 2012
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapy Assistant | 225200000X | A3159 | MD | Primary |
Addresses
Primary practice location
100 E Carroll St
St 3
Salisbury, MD 21801-5422
Mailing address
717 Hurley Park Dr
Seaford, DE 19973-1319
Phone (302) 682-9373
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| A3159 | MD | MD | Physical Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1340582400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1340582400000",
"number": "1881957884",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "717 HURLEY PARK DR",
"city": "SEAFORD",
"state": "DE",
"postal_code": "199731319",
"telephone_number": "302-682-9373"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "100 E CARROLL ST",
"address_2": "ST 3",
"city": "SALISBURY",
"state": "MD",
"postal_code": "218015422",
"telephone_number": "410-546-6400"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BOGLE",
"first_name": "KIRK-JOHN",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2012-06-25",
"last_updated": "2012-06-25",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "MD",
"license": "A3159",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Salisbury, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.