Individual provider Active NPI

Mirabell Neh Boma, RN

  • Registered Nurse
  • Kansas City, MO
National Provider Identifier
1124824636
Registry record updated Feb 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
2021046277 Issued in MO
Practice address
4801 E Linwood Blvd
Kansas City, MO 64128-2226
Phone
(816) 861-4700
NPI assigned
Feb 24, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 24, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 2021046277 MO Primary

Addresses

Primary practice location

4801 E Linwood Blvd
Kansas City, MO 64128-2226

Mailing address

4017 SW Flintrock Dr
Lees Summit, MO 64082-4872
Phone (240) 330-0672

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
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
2021046277MOMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1740355200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740355200000",
    "number": "1124824636",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4017 SW FLINTROCK DR",
            "city": "LEES SUMMIT",
            "state": "MO",
            "postal_code": "640824872",
            "telephone_number": "240-330-0672"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4801 E LINWOOD BLVD",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641282226",
            "telephone_number": "816-861-4700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOMA",
        "first_name": "MIRABELL",
        "middle_name": "NEH",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-02-24",
        "last_updated": "2025-02-24",
        "certification_date": "2025-02-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MO",
            "license": "2021046277",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kansas City, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2025; 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.