Individual provider Active NPI

Michael Boykin, MD

  • Neurology Physician
  • West Monroe, LA
National Provider Identifier
1063471670
Registry record updated Aug 19, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
10982 Issued in LA
Practice address
122 Professional Drive
West Monroe, LA 71291
Phone
(318) 807-4611
Fax
(318) 807-4615
NPI assigned
Mar 22, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 19, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X 10982 LA Primary

Addresses

Primary practice location

122 Professional Drive
West Monroe, LA 71291

Mailing address

122 Professional Drive
West Monroe, LA 71291
Phone (318) 807-4611

Other identifiers 2

IdentifierTypeStateIssuer
1148113MedicaidLA
H05015OtherLAVANTAGE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
10982LAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
SFN Professional Management Past Accepting new patients
Physician Billing SFN PastSince Nov 1, 2005 Accepting new patients
Michael Edward Boykin, M.D., a Medical Corporation PastSince Jan 1, 1990 Accepting new patients
Columbia Healthcare Systems of la, Inc Past Accepting new patients

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": "1142985600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1408406400000",
    "number": "1063471670",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "122 PROFESSIONAL DRIVE",
            "city": "WEST MONROE",
            "state": "LA",
            "postal_code": "71291",
            "telephone_number": "318-807-4611",
            "fax_number": "318-807-4615"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "122 PROFESSIONAL DRIVE",
            "city": "WEST MONROE",
            "state": "LA",
            "postal_code": "71291",
            "telephone_number": "318-807-4611",
            "fax_number": "318-807-4615"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOYKIN",
        "first_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-22",
        "last_updated": "2014-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "LA",
            "license": "10982",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1148113",
            "state": "LA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VANTAGE",
            "identifier": "H05015",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in West Monroe, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2014; 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.