KRISTINA NICHOLE BOGAR (D.O.) – Family Medicine Physician, NPI 1497793186

KRISTINA NICHOLE BOGAR (D.O.) is a healthcare provider. based in Kennesaw, Georgia. specializing in Family Medicine Physician. They hold the professional credentials D.O.. They hold a License No. M0667 (TX). The NPI Number for KRISTINA NICHOLE BOGAR (D.O.) is 1497793186

Main info

Female
24 Years Of Experience
Accepts Medicare Assignment
Name
KRISTINA NICHOLE BOGAR (D.O.)
NPI
1497793186
Phone
(770) 456-5941
Address
3450 ACWORTH DUE WEST RD
Enumeration Date
3 June 2006
Last Update Date
23 January 2020

Doctor Profile

Medical School Name
OTHER
Secondary Phone
7704565941
Graduation Year
2002 (24 years ago)
PAC ID
4688695687
Professional Enrollment ID
I20111209000402
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience73
Completeness75
Years active:20State licenses:2Digital endpointsOther names

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Provider Addresses for KRISTINA NICHOLE BOGAR (D.O.)

  • Acworth Due West Road Northwest, Stilesboro Hills, Kennesaw, Cobb County, Georgia, 30152, United States

    BLDG 200, SUITE 220

    KENNESAW, GA 301443335

    Phone: (770) 456-5941

    Fax: (770) 456-5942

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2011-12-09

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Past revalidation due date

Earliest CMS due date was 2023-12-31 (889 days ago).

Enrollment records

1

Earliest due date

2023-12-31

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20111209000402IFamily PracticeGA2023-12-31

What to do next

  • Verify current status on the CMS Revalidation Lookup Tool immediately.
  • Complete revalidation in PECOS or contact your Medicare Administrative Contractor (MAC).
  • Overdue revalidation can lead to deactivation of Medicare billing privileges.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 30144)

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Reviews

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Frequently asked questions

How is KRISTINA NICHOLE BOGAR (D.O.) identified in CMS data?
CMS-hosted NPPES data lists KRISTINA NICHOLE BOGAR (D.O.) with NPI 1497793186.
Can I rely on KRISTINA NICHOLE BOGAR (D.O.) being an active provider?
As of the registry snapshot, KRISTINA NICHOLE BOGAR (D.O.) is marked active.
What is KRISTINA NICHOLE BOGAR (D.O.)'s primary classification?
Family Medicine Physician is the headline specialty for KRISTINA NICHOLE BOGAR (D.O.) here. Clinical services aligned with this taxonomy classification.
Where is KRISTINA NICHOLE BOGAR (D.O.) based?
KRISTINA NICHOLE BOGAR (D.O.) is tied to Kennesaw, Georgia in the data we show; additional addresses may exist on the full record.
How many locations tie to this NPI?
2 practice locations appear in the available data.

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