Leon Bohanan Jr., RN

Primary specialty

Home Health Registered NurseTaxonomy code 163WH0200X

License

RN128692 Issued in GA

Practice address

2316 Butler Bridge Rd
Covington, GA 30016-4927

Phone

(770) 383-5889

NPI assigned

Dec 15, 2011

Sex

Male

Sole proprietor

No

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Nurse

State licenses

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Dec 15, 2011.

{
    "created_epoch": "1323907200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1323907200000",
    "number": "1124397419",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2316 BUTLER BRIDGE RD",
            "city": "COVINGTON",
            "state": "GA",
            "postal_code": "300164927",
            "telephone_number": "770-383-5889"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2316 BUTLER BRIDGE RD",
            "city": "COVINGTON",
            "state": "GA",
            "postal_code": "300164927",
            "telephone_number": "770-383-5889"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOHANAN",
        "first_name": "LEON",
        "name_prefix": "Mr.",
        "name_suffix": "Jr.",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-12-15",
        "last_updated": "2011-12-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "GA",
            "license": "RN128692",
            "primary": false
        },
        {
            "code": "163WH0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Home Health",
            "state": "GA",
            "license": "RN128692",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tiffany Blamble, PA-C
• Christy Blanchford, M.D.
• Destiny Blocker
• Jimmy Lee Blount, DDS
• Denicia Adoniya Boatswain
• Jennifer Bohannon
• Britsheny Bolaji
• Dorcas Bolaji, APRN
• Timothy Irvin Bolen, LPC
• Bomed Health and Compliance

• All providers in Covington, GA
• Home Health Registered Nurse in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 2011; 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.