Charles Joseph Bohle Jr., D.M.D.

Primary specialty

DentistTaxonomy code 122300000X

License

5637 Issued in KY

Practice address

1836 Broadway St
Paducah, KY 42001-2708

Phone

(270) 442-0256

Fax

(270) 442-8730

NPI assigned

Aug 11, 2006

Last updated

Feb 24, 2014By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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 KY

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

All facility ownership & control disclosures 3

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

Owned or controlled facilities with NPI records 4

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

• Mercy Health-Lourdes Hospital LLC

  • Clinical Medical Laboratory
  • Paducah, KY
  • NPI 1245620640

  Corporate Director

  CMS ownership
• Mercy Health-Lourdes Hospital LLC

  • General Acute Care Hospital
  • Paducah, KY
  • NPI 1346244126

  Corporate Director

  CMS ownership
• Mercy Health-Lourdes Hospital LLC

  dba Lourdes - Rehab

  • Rehabilitation Hospital Unit
  • Paducah, KY
  • NPI 1417951468

  Corporate Director

  CMS ownership
• Mercy Health-Lourdes Hospital LLC

  dba Mercy Health - Marshall Family Medicine, Internal Medicine & Pediatric

  • Rural Health Clinic/Center
  • Benton, KY
  • NPI 1629852678

  Corporate Director

  CMS ownership

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.

• Bohle Family Dentistry, PSC

  • Dental Clinic/Center
  • Paducah, KY
  • NPI 1003135534
  Authorized official Same address or phone
• Ky Dental Professionals PSC

  • Dentist
  • Bowling Green, KY
  • NPI 1538601943
  NPD (past)

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

{
    "created_epoch": "1155254400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1393200000000",
    "number": "1922010974",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1836 BROADWAY ST",
            "city": "PADUCAH",
            "state": "KY",
            "postal_code": "420012708",
            "telephone_number": "270-442-0256",
            "fax_number": "270-442-8730"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1836 BROADWAY ST",
            "city": "PADUCAH",
            "state": "KY",
            "postal_code": "420012708",
            "telephone_number": "270-442-0256",
            "fax_number": "270-442-8730"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOHLE",
        "first_name": "CHARLES",
        "middle_name": "JOSEPH",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "D.M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-11",
        "last_updated": "2014-02-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "KY",
            "license": "5637",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sarah Bogard
• Kevin Lee Boggess, LCSW
• Anthony L Bohannon, PT
• Michelle Bohanon, RPH, BCPS
• Bohle Family Dentistry, PSC
• Maria M Bokeno
• Anita Diane Bolin
• Roy Thomas Bolin II, DMD
• Bon Secours Mercy Health Virtual Care LLC (Mercy Health - Virtual Care)
• Christi L Bonds, MD

• Dentist in Paducah, KY
• Providers in Paducah, KY by specialty
• Dentist in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.