Active NPI
Olivia Boatright
- Licensed Practical Nurse
- Wewahitchka, FL
National Provider Identifier
1225296171
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Licensed Practical Nurse
- License
- PN515608
- Practice address
- 612 Canning Dr
Wewahitchka, FL 32465-4710 - Phone
- (850) 639-2274
- Fax
- (850) 639-2274
- NPI assigned
- May 28, 2008
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Licensed Practical Nurse | 164W00000X | PN515608 | FL | Primary |
Addresses
Primary practice location
612 Canning Dr
Wewahitchka, FL 32465-4710
Mailing address
612 Canning Dr
Wewahitchka, FL 32465-4710
Phone (850) 639-2274
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 230628000 | Medicaid | FL |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PN515608 | FL | MD | Licensed Practical Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1211932800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1211932800000",
"number": "1225296171",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "612 CANNING DR",
"city": "WEWAHITCHKA",
"state": "FL",
"postal_code": "324654710",
"telephone_number": "850-639-2274",
"fax_number": "850-639-2274"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "612 CANNING DR",
"city": "WEWAHITCHKA",
"state": "FL",
"postal_code": "324654710",
"telephone_number": "850-639-2274",
"fax_number": "850-639-2274"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BOATRIGHT",
"first_name": "OLIVIA",
"name_prefix": "Mrs.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2008-05-28",
"last_updated": "2008-05-28",
"status": "A"
},
"taxonomies": [
{
"code": "164W00000X",
"taxonomy_group": "",
"desc": "Licensed Practical Nurse",
"state": "FL",
"license": "PN515608",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "230628000",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Wewahitchka, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 28, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.