Joseph McKinley Boster, D.M.D.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

5144 Issued in KY

Practice address

2205 Cumberland Ave
Middlesboro, KY 40965-2832

Phone

(606) 248-3674

Fax

(606) 248-7277

NPI assigned

Jan 30, 2007

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

Other identifiers 2

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

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

{
    "created_epoch": "1170115200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1013054311",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2205 CUMBERLAND AVE",
            "city": "MIDDLESBORO",
            "state": "KY",
            "postal_code": "409652832",
            "telephone_number": "606-248-3674",
            "fax_number": "606-248-7277"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2205 CUMBERLAND AVE",
            "city": "MIDDLESBORO",
            "state": "KY",
            "postal_code": "409652832",
            "telephone_number": "606-248-3674",
            "fax_number": "606-248-7277"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOSTER",
        "first_name": "JOSEPH",
        "middle_name": "MCKINLEY",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-30",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "KY",
            "license": "5144",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "60051448",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE BOARD OF DENTISTRY",
            "identifier": "5144",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Blue Mountain Medical Clinic, PLLC
• Bluegrass Adult Care, LLC
• Charles Bruce Boggs II, PHARM.D.
• Alyssa Boldin, NP
• Holly Renee Booth, O.D.
• Bowkirk Medical (Peoples Choice Pharmacy)
• Taylor Bowling, OT
• Bright Future Primary Care
• Bright Future Primary Care, Inc.
• Aimee Nicole Brock, A.P.R.N., F.N.P.-B.C

• General Practice Dentistry in Middlesboro, KY
• Providers in Middlesboro, KY by specialty
• General Practice Dentistry in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.