Jerry D. Boggs, M.D.

Primary specialty

Neurology PhysicianTaxonomy code 2084N0400X

License

MD20969 Issued in OR

Practice address

1741 West Harvard Ave
Roseburg, OR 97471-2716

Phone

(541) 440-5320

Fax

(541) 440-5322

NPI assigned

Dec 2, 2005

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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

{
    "created_epoch": "1133481600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1441843200000",
    "number": "1003890153",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1700",
            "city": "ROSEBURG",
            "state": "OR",
            "postal_code": "974700414",
            "telephone_number": "541-440-5320",
            "fax_number": "541-440-5322"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1741 WEST HARVARD AVE",
            "city": "ROSEBURG",
            "state": "OR",
            "postal_code": "974712716",
            "telephone_number": "541-440-5320",
            "fax_number": "541-440-5322"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOGGS",
        "first_name": "JERRY",
        "middle_name": "D.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-02",
        "last_updated": "2015-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "OR",
            "license": "MD20969",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "151137",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Joshua Andrew Boele, PA-C
• Craig Boerste
• Brian K Bogardus, DMD
• Kaitlyn E Bogardus, PA-C
• Elizabeth Victoria Boggio, MD
• Valerie Kaye Boggs
• Mark Bogle
• Diane Bolduc, M.D.
• Brandon W Bonds, MD
• Anvi Bonn

• Neurology Physician in Roseburg, OR
• Providers in Roseburg, OR by specialty
• Neurology Physician in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.