Gerald E Boone, PA CERTIFIED PAC
Individual provider Active NPI Family Medicine Physician · Artesia, NM
NPI 1134212921 · NPPES record last updated Jan 25, 2010
Key facts
- NPI
- 1134212921
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- PA065 (NM)
- Practice address
- 301 S Roselawn
Artesia, NM 88210 - Phone
- (575) 746-3616
- Fax
- (575) 748-2544
- NPI assigned
- Oct 2, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PA065 | NM | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Zencare Family Wellness LLC | Family Medicine | Past |
Accepting new patients |
| Artesia General Hospital | Past | Accepting new patients |
Interoperability endpoints
- https://api.platform.athenahealth.com/25994/brand/1/csg/1/fhir/r4
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | PA065 | NM | Yes |
Addresses
Primary practice location
301 S Roselawn
Artesia, NM 88210
Mailing address
301 S Roselawn
Artesia, NM 88210
Phone (575) 746-3616
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| NMEX PA 065 | Other | NM | NMEX PA 065 |
| 72094 | Medicaid | NM |
Other providers in Artesia, NM
- Chelsea Janette Bilberry
- Bailey Vaughan Blackwell
- Stephanie L Blackwood
- Blue Star Therapy, LLC
- Kylar M Boggs
- Cierra Boyce
- Angelica R Branch
- Shawna C Braswell
- Amber Leigh Bratcher
- Mary Angelica Bratcher
All providers in Artesia, NM · Family Medicine Physician in New Mexico
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 25, 2010. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.