Taylar Boerema

Key facts

NPI

1245042860

Entity type

Individual (NPI type 1)

Primary specialty

Physician Assistant 363A00000X

Practice address

25459 608TH Ave
Litchfield, MN 55355-5853

Phone

(320) 339-6646

NPI assigned

Jan 21, 2025

Sex

Female

Sole proprietor

No

Medicare participation

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)

No

Specialties & licenses

Addresses

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Jan 21, 2025.

{
    "created_epoch": "1737417600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1737417600000",
    "number": "1245042860",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25459 608TH AVE",
            "city": "LITCHFIELD",
            "state": "MN",
            "postal_code": "553555853"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25459 608TH AVE",
            "city": "LITCHFIELD",
            "state": "MN",
            "postal_code": "553555853",
            "telephone_number": "320-339-6646"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "25459 608th Ave",
            "address_purpose": "LOCATION",
            "city": "Litchfield",
            "state": "MN",
            "postal_code": "553555853",
            "country_code": "US",
            "telephone_number": "320-339-6646",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BOEREMA",
        "first_name": "TAYLAR",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-01-21",
        "last_updated": "2025-01-21",
        "certification_date": "2025-01-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Wylie Boehmlehner, BA, LADC
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• Pamela L Brett, DO
• Doug P Briggman, NP-C
• Emily Brookshaw, D.P.T, P.T
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All providers in Litchfield, MN · Physician Assistant in Minnesota