Kenneth Carter Boatner, ED.D.,MPH

Primary specialty

PsychologistTaxonomy code 103T00000X

License

003786 Issued in GA

Practice address

565 Peachtree Street, N.E.
Suite 1407
Atlanta, GA 30308-2277

Phone

(617) 784-3535

NPI assigned

Jul 30, 2015

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1438214400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1439337600000",
    "number": "1306221411",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "565 PEACHTREE ST NE UNIT 1407",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303082277",
            "telephone_number": "617-784-3535"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "565 PEACHTREE STREET, N.E.",
            "address_2": "SUITE 1407",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303082277",
            "telephone_number": "617-784-3535"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOATNER",
        "first_name": "KENNETH",
        "middle_name": "CARTER",
        "name_prefix": "Mr.",
        "credential": "ED.D.,MPH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-07-30",
        "last_updated": "2015-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "GA",
            "license": "003786",
            "primary": true
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MA",
            "license": "4286",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Board of Regents of the University System of Georgia and on Behalf....
• Kelly Board, APRN, NP-C
• Afua Sarpon Boaten, MD
• Adedoyin Boatin, PHARMD
• Connie Reynolds Boatman, MPA, PA-C
• Pamela Boatner, CNM
• Emyshia Boatwright
• Bob Schumacher, D.C., P.C.
• Kaylin Bob
• Bobb G Cucher MD and Caroline M Abruzese MD LLC

• Psychologist in Atlanta, GA
• Providers in Atlanta, GA by specialty
• Psychologist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2015; 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.