Vicki Bolger

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

01129 Issued in MO

Practice address

16460 Horseshoe Ridge Rd
Chesterfield, MO 63005-4422

Phone

(314) 409-7525

NPI assigned

Dec 28, 2011

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

Enrolled in MO

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 1980

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Smart Rehab, LLCGroup PAC ID 1759668643, 23 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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

• Smart Rehab, LLC

  • Physical Therapist
  • Kirkwood, MO
  • NPI 1144760471
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1325030400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1325030400000",
    "number": "1912276551",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16460 HORSESHOE RIDGE RD",
            "city": "CHESTERFIELD",
            "state": "MO",
            "postal_code": "630054422"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16460 HORSESHOE RIDGE RD",
            "city": "CHESTERFIELD",
            "state": "MO",
            "postal_code": "630054422",
            "telephone_number": "314-409-7525"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOLGER",
        "first_name": "VICKI",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-12-28",
        "last_updated": "2011-12-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MO",
            "license": "01129",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Giovanina Bohn
• Kelley Boland, CST
• Meaghan Boland, FNP-BC
• Michael F Boland, M.D.
• Bold Serenity Inc (Fyzical Therapy & Balance Centers)
• Kristen Bollier
• Eve E. Bonic, D.C.
• Ursula Bonner Wright
• Ralph Michael Bonofiglio II, RPH
• Jan H Boon, MD

• Physical Therapist in Chesterfield, MO
• Providers in Chesterfield, MO by specialty
• Physical Therapist in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 28, 2011; 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.