Individual provider Active NPI

Charles Wayne Boyles

  • School Registered Nurse
  • Kansas City, MO
National Provider Identifier
1346078938
Registry record updated Jul 24, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
School Registered NurseTaxonomy code 163WS0200X
License
2024020704 Issued in MO
Practice address
11115 Bennington Ave
Kansas City, MO 64134-3106
Phone
(614) 736-2814
NPI assigned
Jul 24, 2024
Last updated
Jul 24, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 24, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
School Registered Nurse 163WS0200X 2024020704 MO Primary

Addresses

Primary practice location

11115 Bennington Ave
Kansas City, MO 64134-3106

Mailing address

617 E 40TH St
Kansas City, MO 64110-1101

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

LicenseStateTypeSpecialty
2024020704MOMDSchool Registered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1721779200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721779200000",
    "number": "1346078938",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "617 E 40TH ST",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641101101"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11115 BENNINGTON AVE",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641343106",
            "telephone_number": "614-736-2814"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOYLES",
        "first_name": "CHARLES",
        "middle_name": "WAYNE",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-07-24",
        "last_updated": "2024-07-24",
        "certification_date": "2024-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WS0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, School",
            "state": "MO",
            "license": "2024020704",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kansas City, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2024; 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.