Active NPI
Heidi Bohl, LAT
- Athletic Trainer
- Appleton, WI
National Provider Identifier
1932716784
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- Practice address
- 2105 E Enterprise Ave Ste 113
Appleton, WI 54913-7862 - Phone
- (920) 991-2561
- NPI assigned
- Sep 25, 2020
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Athletic Trainer | 2255A2300X | Primary |
Addresses
Primary practice location
2105 E Enterprise Ave Ste 113
Appleton, WI 54913-7862
Mailing address
W6826 County Road O
Hortonville, WI 54944-9742
Phone (920) 740-8520
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | ConnectED |
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1600992000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1600992000000",
"number": "1932716784",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "W6826 COUNTY ROAD O",
"city": "HORTONVILLE",
"state": "WI",
"postal_code": "549449742",
"telephone_number": "920-740-8520"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2105 E ENTERPRISE AVE STE 113",
"city": "APPLETON",
"state": "WI",
"postal_code": "549137862",
"telephone_number": "920-991-2561"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BOHL",
"first_name": "HEIDI",
"credential": "LAT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-09-25",
"last_updated": "2020-09-25",
"certification_date": "2020-09-25",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "CONNECT",
"endpointTypeDescription": "CONNECT URL",
"endpoint": "ConnectED",
"affiliation": "N",
"address_1": "2105 E Enterprise Ave Ste 113",
"city": "Appleton",
"state": "WI",
"country_code": "US",
"postal_code": "549137862",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Appleton, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.