Individual provider Active NPI

Christopher T Boehman, PAC

  • Physician Assistant
  • Marysville, OH
National Provider Identifier
1033165691
Registry record updated Apr 6, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
5000850 Issued in OH
Practice address
500 London Ave
Marysville, OH 43040-5512
Phone
(937) 644-6115
Fax
(937) 578-2812
NPI assigned
May 25, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 6, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 5000850 OH Primary

Addresses

Primary practice location

500 London Ave
Marysville, OH 43040-5512

Mailing address

4750 Hempstead Station Dr
Kettering, OH 45429-5164
Phone (800) 875-0136

Electronic endpoints 3

TypeEndpointUseAffiliation
Direct Messaging Address cboehman163126@direct.wvuhsdirect.com Health Information Exchange (HIE)
Direct Messaging Address cboehman163126@direct.wvuhsdirect.com Health Information Exchange (HIE)
Direct Messaging Address cboehman163126@direct.wvuhsdirect.com Health Information Exchange (HIE)

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WV
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060106000399 WV Practitioner - Physician Assistant 1254321185 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
95.34 of 100Reported as apm
Quality
79.86
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
5000850OHMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
West Virginia University Medical Corporation CurrentSince May 4, 2020 Accepting new patients
West Virginia University Medical Corporation CurrentSince May 4, 2020 Accepting new patients
Marysville Emergency Physicians Inc. Past Accepting new patients
West Virginia University Medical Corporation Past Accepting new patients

Locations

327 Medical Park Dr
Bridgeport, WV 26330
Phone (681) 342-1000

1325 Locust Ave
Fairmont, WV 26554
Phone (304) 367-7100

600 Suncrest Town Centre Dr
Ste 310
Morgantown, WV 26505
Phone (304) 598-2200

301 Suncrest Town Centre Dr
Morgantown, WV 26505
Phone (304) 598-8908

390 Birch St
Ste B
Morgantown, WV 26506
Phone (304) 285-7200

1 Medical Center Dr
Morgantown, WV 26506
Phone (304) 293-4500

Interoperability endpoints

  • Direct secure messaging: cboehman163126@direct.wvuhsdirect.com

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1148515200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1649203200000",
    "number": "1033165691",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4750 HEMPSTEAD STATION DR",
            "city": "KETTERING",
            "state": "OH",
            "postal_code": "454295164",
            "telephone_number": "800-875-0136",
            "fax_number": "937-619-4231"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 LONDON AVE",
            "city": "MARYSVILLE",
            "state": "OH",
            "postal_code": "430405512",
            "telephone_number": "937-644-6115",
            "fax_number": "937-578-2812"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOEHMAN",
        "first_name": "CHRISTOPHER",
        "middle_name": "T",
        "credential": "PAC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-25",
        "last_updated": "2022-04-06",
        "certification_date": "2022-04-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OH",
            "license": "5000850",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "cboehman163126@direct.wvuhsdirect.com",
            "affiliation": "N",
            "endpointDescription": "Direct Address",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1 Medical Center Dr",
            "city": "Morgantown",
            "state": "WV",
            "country_code": "US",
            "postal_code": "265061200",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "cboehman163126@direct.wvuhsdirect.com",
            "affiliation": "N",
            "endpointDescription": "Direct Address",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1325 Locust Ave",
            "city": "Fairmont",
            "state": "WV",
            "country_code": "US",
            "postal_code": "265541435",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "cboehman163126@direct.wvuhsdirect.com",
            "affiliation": "N",
            "endpointDescription": "Direct Address",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1325 Locust Ave",
            "city": "Fairmont",
            "state": "WV",
            "country_code": "US",
            "postal_code": "265541435",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Marysville, OH

Sources for this page

Verify at the official NPI Registry.