Active NPI
Michael Boose
- Homemaker
- Belleville, IL
National Provider Identifier
1104550706
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Homemaker
- Practice address
- 25 Kingery CT Apt 38
Belleville, IL 62226-6280 - Phone
- (618) 381-2886
- NPI assigned
- Jul 11, 2022
- Last updated
- Jul 11, 2022
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Homemaker | 376J00000X | Primary |
Addresses
Primary practice location
25 Kingery CT Apt 38
Belleville, IL 62226-6280
Mailing address
25 Kingery CT Apt 38
Belleville, IL 62226-6280
Phone (618) 381-2886
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1657497600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1657497600000",
"number": "1104550706",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "25 KINGERY CT APT 38",
"city": "BELLEVILLE",
"state": "IL",
"postal_code": "622266280",
"telephone_number": "618-381-2886"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "25 KINGERY CT APT 38",
"city": "BELLEVILLE",
"state": "IL",
"postal_code": "622266280",
"telephone_number": "618-381-2886"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BOOSE",
"first_name": "MICHAEL",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2022-07-11",
"last_updated": "2022-07-11",
"certification_date": "2022-07-11",
"status": "A"
},
"taxonomies": [
{
"code": "376J00000X",
"taxonomy_group": "",
"desc": "Homemaker",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Belleville, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.