Douglas Kent Boehm, MD

Primary specialty

Cardiovascular Disease PhysicianTaxonomy code 207RC0000X

License

65012 Issued in MN

Practice address

640 Jackson St
Saint Paul, MN 55101

Phone

(651) 254-4887

NPI assigned

Sep 26, 2005

Last updated

Feb 7, 2019By 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 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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.

• Pocatello Cardiology Associates

  • Adult Health Clinical Nurse Specialist
  • Pocatello, ID
  • NPI 1659540292
  NPD (past)
• Pocatello Health Services, LLC

  • Cardiovascular Disease Physician
  • Pocatello, ID
  • NPI 1992713432
  NPD (past)

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

{
    "created_epoch": "1127692800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1549497600000",
    "number": "1215923172",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8170 33RD AVE S # MS 21110Q",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554254516",
            "telephone_number": "651-254-4887"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "640 JACKSON ST",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "55101",
            "telephone_number": "651-254-4887"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "400 Burdick Expy E",
            "address_purpose": "LOCATION",
            "city": "Minot",
            "state": "ND",
            "postal_code": "587014768",
            "country_code": "US",
            "telephone_number": "701-857-7840",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "777 Hospital Way Bldg A",
            "address_2": "Ste. 101",
            "address_purpose": "LOCATION",
            "city": "Pocatello",
            "state": "ID",
            "postal_code": "832012753",
            "country_code": "US",
            "telephone_number": "208-234-2001",
            "fax_number": "208-232-2195",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BOEHM",
        "first_name": "DOUGLAS",
        "middle_name": "KENT",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-26",
        "last_updated": "2019-02-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "MN",
            "license": "65012",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003605800",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Body Whispers Therapy LLC
• Laura A. Boe, M.A. L.P.
• Paige Noel Boedecker
• Angela Marie Boehm
• Curtis A Boehm, MD
• Sarah Jean Boehne, LICSW
• Ann Elizabeth Boekhoff, MA LP LMFT
• Morgan Boeltl, MS
• Dawn Louise Boettcher, LP
• Melissa Bofenkamp, LPCC

• Cardiovascular Disease Physician in Saint Paul, MN
• Providers in Saint Paul, MN by specialty
• Cardiovascular Disease Physician in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 2019; 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.