Active NPI
Michael Joseph Boehke, ATC
- Athletic Trainer
- Philippi, WV
National Provider Identifier
1225438252
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- AT001094
- Practice address
- 101 College Hill Drive, Box 2061
Philippi, WV 26416 - Phone
- (304) 457-6300
- NPI assigned
- Aug 27, 2014
- Last updated
- Aug 27, 2014
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Athletic Trainer | 2255A2300X | AT001094 | WV | Primary |
Addresses
Primary practice location
101 College Hill Drive, Box 2061
Philippi, WV 26416
Mailing address
Box 2061, 101 College Hill Drive
Philippi, WV 26416
Phone (304) 457-6300
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 |
|---|---|---|---|
| AT001094 | WV | MD | Athletic Trainer |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1409097600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1409097600000",
"number": "1225438252",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "BOX 2061, 101 COLLEGE HILL DRIVE",
"city": "PHILIPPI",
"state": "WV",
"postal_code": "26416",
"telephone_number": "304-457-6300"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "101 COLLEGE HILL DRIVE, BOX 2061",
"city": "PHILIPPI",
"state": "WV",
"postal_code": "26416",
"telephone_number": "304-457-6300"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BOEHKE",
"first_name": "MICHAEL",
"middle_name": "JOSEPH",
"credential": "ATC",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2014-08-27",
"last_updated": "2014-08-27",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "WV",
"license": "AT001094",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Philippi, WV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.