Jason Ryan Boberg

Primary specialty

Pharmacotherapy PharmacistTaxonomy code 1835P1200X

License

RP00008913 Issued in NM

Practice address

2211 Lomas Blvd NE
Albuquerque, NM 87106-2719

Phone

(505) 272-7697

NPI assigned

Jul 10, 2023

Last updated

Jul 10, 2023By 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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1688947200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1688947200000",
    "number": "1235817289",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6308 ALPENGLOW TRL NE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871133401",
            "telephone_number": "505-239-7584"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2211 LOMAS BLVD NE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871062719",
            "telephone_number": "505-272-7697"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOBERG",
        "first_name": "JASON",
        "middle_name": "RYAN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-07-10",
        "last_updated": "2023-07-10",
        "certification_date": "2023-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1835P1200X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Pharmacotherapy",
            "state": "NM",
            "license": "RP00008913",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Jackie Bocanegra
• Kimberly A Bocaz, CNP
• Bocephus Recovery Corp
• Edward S Bocian Jr., MD
• Justus Dillion Bock

• Pharmacotherapy Pharmacist in Albuquerque, NM
• Providers in Albuquerque, NM by specialty
• Pharmacotherapy Pharmacist in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2023; 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.