Kelly Jo Boeve, LLP

Primary specialty

Intellectual & Developmental Disabilities PsychologistTaxonomy code 103TM1800X

License

6301011390 Issued in MI

Practice address

12265 James St
Holland, MI 49424-8613

Phone

(616) 393-5698

Fax

(616) 393-5687

NPI assigned

Mar 30, 2011

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Ms. Kelly Jo Van Valkenburg Former name

Medicare fee-for-service enrollment

Enrolled in MI

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• County of Ottawa

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Holland, MI
  • NPI 1619932381
  Medicare reassignment NPD
• County of Ottawa

  • Non-Surgical Family Planning Clinic/Center
  • Holland, MI
  • NPI 1679653422
  NPD
• Ottawa County CMH

  • Community/Behavioral Health Agency
  • Grand Haven, MI
  • NPI 1346329570
  NPD (past)

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

{
    "created_epoch": "1301443200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1301443200000",
    "number": "1063701175",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12265 JAMES ST",
            "city": "HOLLAND",
            "state": "MI",
            "postal_code": "494248613",
            "telephone_number": "616-393-5698",
            "fax_number": "616-393-5687"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12265 JAMES ST",
            "city": "HOLLAND",
            "state": "MI",
            "postal_code": "494248613",
            "telephone_number": "616-393-5698",
            "fax_number": "616-393-5687"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOEVE",
        "first_name": "KELLY",
        "middle_name": "JO",
        "name_prefix": "Ms.",
        "credential": "LLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-03-30",
        "last_updated": "2011-03-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TM1800X",
            "taxonomy_group": "",
            "desc": "Psychologist, Intellectual & Developmental Disabilities",
            "state": "MI",
            "license": "6301011390",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KELLY",
            "last_name": "VAN VALKENBURG",
            "middle_name": "JO",
            "prefix": "MS.",
            "credential": "LLP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Jennifer Boerman
• Rachele Boerman
• Quinne Boersma, OTR
• Brian C Boeve
• Cameron Paige Boeve, LLMSW
• Theresa Ann Boeve, OTR/L
• Therese L. Boggiano, RN
• Noelle Abigail Bohannon, PA-C
• Sarah Mae Bolman
• Daniel L Bolt, DDS

• Intellectual & Developmental Disabilities Psychologist in Holland, MI
• Providers in Holland, MI by specialty
• Intellectual & Developmental Disabilities Psychologist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 2011; 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.