Janice J Boge, ARNP
Individual provider Active NPI Nurse Practitioner · Fort Scott, KS
NPI 1164538187 · NPPES record last updated Feb 22, 2011
Key facts
- NPI
- 1164538187
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Nurse Practitioner 363L00000X
- License
- 45022 (KS)
- Practice address
- 403 Woodland Hills Blvd
Fort Scott, KS 66701-8798 - Phone
- (620) 223-8040
- Fax
- (620) 223-8524
- NPI assigned
- Aug 22, 2006
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20211019000789 | IA | Order and Referring Only - Nurse Practitioner | 8527021286 |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 45022 | KS | MD | Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Fort Scott Family Medicine | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | 45022 | KS | Yes |
Addresses
Primary practice location
403 Woodland Hills Blvd
Fort Scott, KS 66701-8798
Mailing address
403 Woodland Hills Blvd
Fort Scott, KS 66701-8798
Phone (620) 223-8040
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 4287244201 | Medicaid | KS |
Other providers in Fort Scott, KS
- Michael Brian Becker
- Charles Vincent Begulia Jr.
- Danielle M Bennett
- Kaley Nicole Binford
- Bio-Medical Applications of Kansas, Inc.
- Bradbury Therapy Consultants, LLC
- Katricia Bradbury
- Paul R Brasuell
- Gary L Brown
- Mark Leslie Brown
All providers in Fort Scott, KS · Nurse Practitioner in Kansas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 22, 2011. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.