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

Organization subpart

No

Name

Mrs. Rachel Stack Boersma

Title

Owner

Phone

(318) 255-2733

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Pamela R Hearn, MD

  • Family Medicine Physician
  • Ruston, LA
  • NPI 1215126834

  Family Medicine

  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

  Family Medicine

  NPD (past)
• Wanda J Sullivan, RN

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

Locations

• Boersma Clinic Former legal business name

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Apr 20, 2008.

{
    "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": "193400000X SINGLE SPECIALTY  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

• All providers in Ruston, LA
• 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.