SHANNON BOGLE (NPI# 1851401582) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1851401582 |
| Entity Type | Individual |
| Full Name | SHANNON BOGLE |
| Credential | PT |
| Practice Address |
2106 S Lois Ave Tampa FL 33629-5659 |
| Mailing Address |
13020 N Telecom Pkwy Temple Terrace FL 33637-0925 |
| Practice Telephone | 8132879370 |
| Enumeration Date | 2006-08-30 |
| Last Update Date | 2010-12-13 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2251X0800X |
Physical Therapist Specialization: Orthopedic |
PT12643 | FL | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | RAILROAD MEDICARE | P00465914 | 01 |
| Street Address |
2106 S LOIS AVE |
| City | TAMPA |
| State | FL |
| Zip Code | 33629-5659 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164412805 | Cynthia Goode | Physical Therapist | 2106 S Lois Ave, Tampa, FL 33629-5602 | 2005-10-25 |
| 1780198168 | Shane Bennett | Nurse Practitioner | 2106 S Lois Ave, Tampa, FL 33629-5659 | 2017-11-21 |
| 1164769063 | Tampa General Medical Group Inc | Family Medicine | 2106 S Lois Ave, Fl 2, Tampa, FL 33629 | 2013-01-11 |
| 1659660009 | Shawn Derek Skaife | Family Medicine | 2106 S Lois Ave, Tampa, FL 33629-5659 | 2011-04-06 |
| 1104145705 | Omar Santana Hernandez | Internal Medicine | 2106 S Lois Ave, Tampa, FL 33629-5659 | 2010-05-20 |
| 1154577930 | Jason Moses Castro | Family Medicine | 2106 S Lois Ave, Tampa, FL 33629-5659 | 2008-08-13 |
| 1902003262 | Pina Panchal | Family Medicine | 2106 S Lois Ave, Tampa, FL 33629-5659 | 2007-06-29 |
| 1073692000 | Raphael Khorran | Family Medicine | 2106 S Lois Ave, Tampa, FL 33629-5659 | 2006-11-02 |
| 1285667253 | Antonio Duroy Farrales | Family Medicine | 2106 S Lois Ave, Tampa, FL 33629-5659 | 2006-07-10 |
| 1740242411 | Tower Imaging Inc | Radiology | 2106 S Lois Ave, Tower Radiology Center South Tampa, Tampa, FL 33629-5602 | 2006-04-06 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689162612 | Jake Morris | Counselor | 4003 W Morrison Ave, Tampa, FL 33629 | 2018-04-25 |
| 1689192411 | Madalyn Turner | Chiropractor | 3409 W Bay To Bay Blvd Ste B, Tampa, FL 33629 | 2017-08-31 |
| 1063865673 | South Tampa Dental Studio | Dentist | 4306 West Kensington Ave., Tampa, FL 33629 | 2016-07-19 |
| 1093198160 | Mi Ae Kwon | Dentist | 3739 W. Neptune St., Tampa, FL 33629 | 2015-07-07 |
| 1013394568 | Etairos Health, Inc | In Home Supportive Care | 2301 W Palm Ave, Tampa, FL 33629 | 2015-05-05 |
| 1053702589 | Kantilal N. Bhadja, Md | Internal Medicine | 4223 W. El Prado Blvd, Tampa, FL 33629 | 2015-02-05 |
| 1801174016 | Wang & Cortes Dental | Dentist | 1008 South Clearview Avenue, Tampa, FL 33629 | 2011-07-22 |
| 1174826176 | Jada Rae Danielle Traub | Behavioral Analyst | 3271 S. Macdill Ave, Tampa, FL 33629 | 2010-12-13 |
| 1275849846 | Kara Dawson | Physical Therapy Assistant | 3614 South Dale Mabry, Tampa, FL 33629 | 2010-08-20 |
| 1225350580 | Monteleone & Kessler, P.l. | Dentist | 4014 W. Estrella St., Suite B, Tampa, FL 33629 | 2010-02-26 |
| Find all providers in zip 33629 | ||||
| Taxonomy Code | 2251X0800X |
| Grouping | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Classification | Physical Therapist |
| Specialization | Orthopedic |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164044590 | Prestige Health & Performance | Physical Therapist | 20354 Chestnut Grove Dr, Tampa, FL 33647-3344 | 2020-05-07 |
| 1710519806 | Shawna Rae Sprout | Physical Therapist | 6417 E County Line Rd Ste 100, Tampa, FL 33647-1855 | 2020-02-07 |
| 1992211767 | Jesse Polanco | Physical Therapist | 4019 Henderson Blvd, Tampa, FL 33629-4939 | 2017-12-15 |
| 1922556448 | Richard Scafidi | Physical Therapist | 1175 E Kennedy Blvd, Apt 843, Tampa, FL 33602-3545 | 2016-09-13 |
| 1477984896 | Gulfcoast Spine Institute Pa | Physical Therapist | 6101 Webb Rd., Suite 304, Tampa, FL 33615-2866 | 2013-12-11 |
| 1659622496 | Maria Ann Silverberg | Physical Therapist | 10414 Butia Pl, Tampa, FL 33618-4118 | 2012-09-19 |
| 1215064944 | Sarah E Swigart | Physical Therapist | 17200 Commerce Park Blvd, Tampa, FL 33647-2600 | 2007-02-28 |
| 1407929359 | Sherrice Broussard Rose | Physical Therapist | 2307 S Dale Mabry Hwy Ste F, Tampa, FL 33629-6322 | 2006-11-16 |
| 1164412805 | Cynthia Goode | Physical Therapist | 2106 S Lois Ave, Tampa, FL 33629-5602 | 2005-10-25 |
| 1508856261 | David Newman | Physical Therapist | 3515 E Fletcher Ave, Mdc 90, Tampa, FL 33613-4706 | 2005-10-25 |
| Find all providers in TAMPA | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.