Jan C Boggs, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

34000520A Issued in IN

Practice address

4656 W Jefferson Blvd
Suite 285
Fort Wayne, IN 46804-6857

Phone

(260) 422-9372

Fax

(260) 422-0843

NPI assigned

Dec 4, 2006

Last updated

Feb 5, 2018By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1165190400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1517788800000",
    "number": "1104994318",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20 GROVE PARK DR",
            "city": "COLUMBIA CITY",
            "state": "IN",
            "postal_code": "467251812",
            "telephone_number": "260-249-8429",
            "fax_number": "260-244-1983"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4656 W JEFFERSON BLVD",
            "address_2": "SUITE 285",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468046857",
            "telephone_number": "260-422-9372",
            "fax_number": "260-422-0843"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOGGS",
        "first_name": "JAN",
        "middle_name": "C",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-04",
        "last_updated": "2018-02-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IN",
            "license": "34000520A",
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IN",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200532500A",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jenna Boese
• Ashley Helene Boettcher, NP-C
• Morgan Bogdanic
• Chad Jakob Boggs, PHARMD
• Chandler Boggs, DC
• Madelyn Brooke Boggs, PA
• Trenton G Boggs, DC
• Kasee Bogle, CFN-P
• Alicia A Bogner, RBT
• Nicole Bogner

• Clinical Social Worker in Fort Wayne, IN
• Providers in Fort Wayne, IN by specialty
• Clinical Social Worker in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2018; 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.