NPIMap

Individual provider Active NPI

Karin B Boeck, M.D.

  • Family Medicine Physician
  • Kimball, TN
National Provider Identifier
1104817774
Registry record updated Aug 6, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD29826 Issued in TN
Practice address
24 Mountain View Drive
Suite a
Kimball, TN 37347
Phone
(423) 942-9171
Fax
(423) 942-9128
NPI assigned
Nov 2, 2005
Last updated
Aug 6, 2010By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 6, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X MD29826 TN Primary

Addresses

Primary practice location

24 Mountain View Drive
Suite a
Kimball, TN 37347

Mailing address

24 Mountain View Drive
Suite a
Kimball, TN 37347
Phone (423) 942-9171

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20031111000598 TN Practitioner - Family Practice 3476466863 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Tennessee, HSC, College of Medicine, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Sequatchie Valley Primary CareGroup PAC ID 7810164050, 5 clinicians

Practice addresses (Care Compare)

24 Mountain View Dr
Suite a
Kimball, TN 37347-5478
Phone (423) 942-9171

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD29826TNMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Sequatchie Valley Primary Care CurrentSince Jan 1, 2012 Accepting new patients
Abode Care Partners Al VB, LLC CurrentSince Sep 25, 2024 Accepting new patients
Abode Care Partners Al VB, LLC CurrentSince Sep 25, 2024 Accepting new patients
Abode Care Partners LTC VB, LLC CurrentSince Sep 25, 2024 Accepting new patients
Abode Care Partners LTC VB, LLC CurrentSince Sep 25, 2024 Accepting new patients
Physician Management Services of Tennessee, LLC Family Medicine Past Accepting new patients
LP South Pittsburg LLC Past Accepting new patients

Locations

805 N Whittington Pkwy
Ste 400
Louisville, KY 40222
Phone (502) 272-3438

805 N Whittington Pkwy
Northfield, KY 40222
Phone (502) 627-7000

24 Mountain View Dr
Ste A
Kimball, TN 37347
Phone (423) 942-9171

919 Medical Park Dr
Mountain City, TN 37683
Phone (423) 727-7800

Organizations & group practices 7

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 8

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1130889600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1281052800000",
    "number": "1104817774",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24 MOUNTAIN VIEW DRIVE",
            "address_2": "SUITE A",
            "city": "KIMBALL",
            "state": "TN",
            "postal_code": "37347",
            "telephone_number": "423-942-9171",
            "fax_number": "423-942-9128"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24 MOUNTAIN VIEW DRIVE",
            "address_2": "SUITE A",
            "city": "KIMBALL",
            "state": "TN",
            "postal_code": "37347",
            "telephone_number": "423-942-9171",
            "fax_number": "423-942-9128"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOECK",
        "first_name": "KARIN",
        "middle_name": "B",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-11-02",
        "last_updated": "2010-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TN",
            "license": "MD29826",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kimball, TN

Sources for this page

Verify at the official NPI Registry.