Boersma Clinic, LLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

BOERSMA CLINIC, LLC

Practice address

765 S Bonner St
Ruston, LA 71270-5801

Phone

(318) 255-2733

Fax

(318) 254-1066

NPI assigned

Jul 6, 2007

Last updated

Apr 20, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mrs. Rachel Stack Boersma

Title

Owner

Phone

(318) 255-2733

Specialties & licenses 1

Addresses

Other names 1

• Boersma Clinic Former legal business name

Locations

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Pamela R Hearn, MD

  • Family Medicine Physician
  • Ruston, LA
  • NPI 1215126834
  NPD (past)
• Charles Edward Self, PA-C

  • Medical Physician Assistant
  • Minden, LA
  • NPI 1497741995
  NPD (past)
• Shannon Dawn Spigener, MD

  • Family Medicine Physician
  • Minden, LA
  • NPI 1669441671
  NPD (past)
• Wanda J Sullivan, RN

  • Nurse Practitioner
  • Ruston, LA
  • NPI 1740360353
  NPD (past)

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

{
    "created_epoch": "1183680000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1208649600000",
    "number": "1104024686",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "765 S BONNER ST",
            "city": "RUSTON",
            "state": "LA",
            "postal_code": "712705801",
            "telephone_number": "318-255-2733",
            "fax_number": "318-254-1066"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "765 S BONNER ST",
            "city": "RUSTON",
            "state": "LA",
            "postal_code": "712705801",
            "telephone_number": "318-255-2733",
            "fax_number": "318-254-1066"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BOERSMA CLINIC, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-07-06",
        "last_updated": "2008-04-20",
        "status": "A",
        "authorized_official_last_name": "BOERSMA",
        "authorized_official_first_name": "RACHEL",
        "authorized_official_middle_name": "STACK",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "318-255-2733",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Boersma Clinic",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

• Aimee Blackham, PHD
• Cody Blackwelder, MD
• Mark Blackwelder, M.D.
• Allie Blackwood, DNP, CRNA
• Madeline Kate Blundell, CCC-SLP
• Taylor Blake Boggs, APRN, FNP-C
• Bonnie Lejeune Buller, LLC
• Heather Taylor Boone
• Brandi Elizabeth Bordelon, FNP-C
• Angelica Boston, RSW

• Family Medicine Physician in Ruston, LA
• Providers in Ruston, LA by specialty
• Family Medicine Physician in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 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.