Sampson Kwabina Boham, DO

Primary specialty

Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X

License

81031-21 Issued in WI

Practice address

430 E Division St
Fond Du Lac, WI 54935-4597

Phone

(920) 926-5800

NPI assigned

May 21, 2018

Last updated

Aug 24, 2025By 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

Medicare fee-for-service enrollment

Enrolled in WI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Pathology

Education

Des Moines University of Osteopathic Medicine and Health Sciences, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Associated Pathologists, SCGroup PAC ID 9739285479, 19 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• SSM Health St Agnes Hospital-Fond Du Lac Hospital, Fond Du Lac, WI, CCN 520088
• Waupun Memorial Hospital Hospital, Waupun, WI, CCN 521327
• Ripon Medical Center Hospital, Ripon, WI, CCN 521321

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

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.

• Associated Pathologists, SC

  • Clinical Pathology/Laboratory Medicine Physician
  • Madison, WI
  • NPI 1396782231
  Medicare reassignment Care Compare group NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Agnesian Healthcare, Inc

  dba SSM Health St Agnes Hospital Fond Du Lac

  • General Acute Care Hospital
  • Fond Du Lac, WI
  • NPI 1346228541
  Care Compare affiliation
• Ripon Medical Center Inc

  dba SSM Health Ripon Community Hospital

  • Critical Access Hospital
  • Ripon, WI
  • NPI 1053362624
  Care Compare affiliation
• Waupun Memorial Hospital

  dba SSM Health Waupun Memorial Hospital

  • Medicare Defined Swing Bed Hospital Unit
  • Waupun, WI
  • NPI 1528046737
  Care Compare affiliation
• Waupun Memorial Hospital

  dba SSM Health Waupun Memorial Hospital

  • Critical Access Hospital
  • Waupun, WI
  • NPI 1548248644
  Care Compare affiliation

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

{
    "created_epoch": "1526860800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1755993600000",
    "number": "1225529654",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "350 W 11TH ST",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462024108",
            "telephone_number": "317-274-2476"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "430 E DIVISION ST",
            "city": "FOND DU LAC",
            "state": "WI",
            "postal_code": "549354597",
            "telephone_number": "920-926-5800"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "620 W Brown St",
            "address_purpose": "LOCATION",
            "city": "Waupun",
            "state": "WI",
            "postal_code": "539631799",
            "country_code": "US",
            "telephone_number": "920-926-5800",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "845 Parkside St",
            "address_purpose": "LOCATION",
            "city": "Ripon",
            "state": "WI",
            "postal_code": "549718505",
            "country_code": "US",
            "telephone_number": "920-926-5800",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BOHAM",
        "first_name": "SAMPSON",
        "middle_name": "KWABINA",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-05-21",
        "last_updated": "2025-08-24",
        "certification_date": "2025-08-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "WI",
            "license": "81031-21",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Thomas Blum
• Renee L Bodary, NP
• Samantha Boehnlein, D.AC, L.AC, CHC
• Tiffany Marie Boelk, APNP
• Jacqueline Lee Bogan, D.O.
• Holly Anne Bohn, DPT
• Ruth Marie Bohn, COTA
• Shirley Bokelman
• George Boling, O.D.
• Michelle L Boodry, LPC

• Anatomic Pathology & Clinical Pathology Physician in Fond Du Lac, WI
• Providers in Fond Du Lac, WI by specialty
• Anatomic Pathology & Clinical Pathology Physician in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.