Dennis M Boeke, DO

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

107694 Issued in MO

Practice address

1521 S 3Rd
Stockton, MO 65785-9608

Phone

(417) 276-5131

Fax

(417) 276-6498

NPI assigned

Aug 14, 2006

Last updated

Dec 29, 2016By the provider in NPPES

Sex

Male

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

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Ozarks Medical Center

  dba Ozarks Healthcare

  • General Acute Care Hospital
  • West Plains, MO
  • NPI 1831115641

  Family Medicine

  NPD (past)

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

{
    "created_epoch": "1155513600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1482969600000",
    "number": "1205849809",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1500 N OAKLAND AVE",
            "city": "BOLIVAR",
            "state": "MO",
            "postal_code": "656133011",
            "telephone_number": "417-328-6501",
            "fax_number": "417-328-6338"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1521 S 3RD",
            "city": "STOCKTON",
            "state": "MO",
            "postal_code": "657859608",
            "telephone_number": "417-276-5131",
            "fax_number": "417-276-6498"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOEKE",
        "first_name": "DENNIS",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-14",
        "last_updated": "2016-12-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MO",
            "license": "DO107694",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MO",
            "license": "107694",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PALMETTO GBA RAILRAOD",
            "identifier": "P00062527",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Brenda L Abercrombie, FNP, CNM
• Behavioral Healthcare of Rural Missouri, Inc
• Leah Blondin, FDN-P
• Rodger S Campbell, MD
• Cedar County Ambulance Dist Inc
• Cedar County Memorial Hospital (Cedar County Family Clinic)
• Cedar County Memorial Hospital (Cedar County Family Clinic)
• Citizens Memorial Health Care Foundation (Lake Stockton Healthcare Facility)

• Family Medicine Physician in Stockton, MO
• Providers in Stockton, MO by specialty
• Family Medicine Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 29, 2016; 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.