Kathey Dianne Boeckmann, A.P.N.

Primary specialty

Women's Health Nurse PractitionerTaxonomy code 363LW0102X

License

A01022 Issued in AR

Practice address

704 Canal Ave E
Wynne, AR 72396-3042

Phone

(870) 239-2101

Fax

(870) 238-4569

NPI assigned

Jun 15, 2006

Sex

Female

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

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• State of Arkansas

  • Home Health Agency
  • Wynne, AR
  • NPI 1255341392
  NPD (past)

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

{
    "created_epoch": "1150329600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1347494400000",
    "number": "1346284841",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21 COUNTY ROAD 628",
            "city": "WYNNE",
            "state": "AR",
            "postal_code": "723968424",
            "telephone_number": "870-588-5256",
            "fax_number": "870-238-4569"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "704 CANAL AVE E",
            "city": "WYNNE",
            "state": "AR",
            "postal_code": "723963042",
            "telephone_number": "870-239-2101",
            "fax_number": "870-238-4569"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOECKMANN",
        "first_name": "KATHEY",
        "middle_name": "DIANNE",
        "credential": "A.P.N.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-15",
        "last_updated": "2012-09-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "AR",
            "license": "A01022",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Billy J. Mitchell Jr
• Allison Breck Birdsong, SPEECH PATHOLOGIST
• Emily Boals
• Boaz & Associates, Inc.
• Paula Boaz, SLP
• Richard Eugene Boeckmann, P.D.
• Katelyn Boles, LPC
• Leah M Boone
• Jessie Bouland, RN
• Asia Corrine Boykin

• Women's Health Nurse Practitioner in Wynne, AR
• Providers in Wynne, AR by specialty
• Women's Health Nurse Practitioner in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2012; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.