Individual provider Active NPI

Diane Jeanne Boomgaarden/Saar, RN

  • Psychiatric/Mental Health Registered Nurse
  • Bemidji, MN
National Provider Identifier
1073783965
Registry record updated Apr 15, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Registered NurseTaxonomy code 163WP0808X
License
R114618-3 Issued in MN
Practice address
1526 30TH St NW
Bemidji, MN 56601-4133
Phone
(218) 751-3280
Fax
(218) 751-3298
NPI assigned
Mar 6, 2008
Last updated
Apr 15, 2008By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 15, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Registered Nurse 163WP0808X R114618-3 MN Primary

Addresses

Primary practice location

1526 30TH St NW
Bemidji, MN 56601-4133

Mailing address

1526 30TH St NW
Bemidji, MN 56601-4133
Phone (218) 751-3280

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)
Not enrolled
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
R114618-3MNMDPsychiatric/Mental Health Registered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1204761600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1208217600000",
    "number": "1073783965",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1526 30TH ST NW",
            "city": "BEMIDJI",
            "state": "MN",
            "postal_code": "566014133",
            "telephone_number": "218-751-3280",
            "fax_number": "218-751-3298"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1526 30TH ST NW",
            "city": "BEMIDJI",
            "state": "MN",
            "postal_code": "566014133",
            "telephone_number": "218-751-3280",
            "fax_number": "218-751-3298"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOOMGAARDEN/SAAR",
        "first_name": "DIANE",
        "middle_name": "JEANNE",
        "name_prefix": "Ms.",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-03-06",
        "last_updated": "2008-04-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WP0808X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health",
            "state": "MN",
            "license": "R114618-3",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bemidji, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 2008; 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.