Samuel Agyenim Boateng, CNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

APRN.CNP.025942 Issued in OH

Practice address

Holy Hills Healthcare Services, LLC
6760 Tussing Road Suite 104
Reynoldsburg, OH 43068-4136

Phone

(614) 626-6000

Fax

(614) 577-0807

NPI assigned

Jan 30, 2020

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

Medicare fee-for-service enrollment

Enrolled in OH

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

Specialty

Nurse Practitioner

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Hospital & facility affiliations

• Grant Medical Center Hospital, Columbus, OH, CCN 360017

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Nurse Practitioner, Nurse Practitioner

Practice roles

Locations

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.

• Living Hope Primary Health Care,LLC

  • Clinic/Center
  • Columbus, OH
  • NPI 1679179980

  OH

  Medicare reassignment NPD Authorized official
• Northstar Family Practice Inc

  • Family Medicine Physician
  • Columbus, OH
  • NPI 1598882904

  OH

  Medicare reassignment NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Ohiohealth Corporation

  • General Acute Care Hospital
  • Columbus, OH
  • NPI 1255377149

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1580342400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1580342400000",
    "number": "1033740824",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "144 BRANDYWINE DR APT B",
            "city": "WESTERVILLE",
            "state": "OH",
            "postal_code": "430811379",
            "telephone_number": "614-806-8865"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "HOLY HILLS HEALTHCARE SERVICES, LLC",
            "address_2": "6760 TUSSING ROAD SUITE 104",
            "city": "REYNOLDSBURG",
            "state": "OH",
            "postal_code": "430684136",
            "telephone_number": "614-626-6000",
            "fax_number": "614-577-0807"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOATENG",
        "first_name": "SAMUEL",
        "middle_name": "AGYENIM",
        "name_prefix": "Mr.",
        "credential": "CNP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-01-30",
        "last_updated": "2020-01-30",
        "certification_date": "2020-01-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OH",
            "license": "APRN.CNP.025942",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Chireshma Biswa
• Cynthia J Black, MD
• Blessed Homecare LLC
• Blessing Home Care & Medical Supplies LLC,
• Juliana Boamah-Acheampong
• Jolenta Boatner
• Ariel Bocook, LCDCII
• Angela Mojisola Bola
• Kwaku Bonsu
• Hope Boren

• All providers in Reynoldsburg, OH
• Family Nurse Practitioner in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2020; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.