Individual provider Active NPI

Cali Inez Boessen

  • Physical Therapy Assistant
  • Jefferson City, MO
National Provider Identifier
1346719176
Registry record updated Nov 22, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
2018037318 Issued in MO
Practice address
1720 Vieth Dr
Jefferson City, MO 65109-2056
Phone
(573) 635-6193
NPI assigned
Nov 22, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 22, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X 2018037318 MO Primary

Addresses

Primary practice location

1720 Vieth Dr
Jefferson City, MO 65109-2056

Mailing address

616 Spring Hill LN
Meta, MO 65058-2025
Phone (573) 690-8520

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
2018037318MOMDPhysical Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1542844800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1542844800000",
    "number": "1346719176",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "616 SPRING HILL LN",
            "city": "META",
            "state": "MO",
            "postal_code": "650582025",
            "telephone_number": "573-690-8520"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1720 VIETH DR",
            "city": "JEFFERSON CITY",
            "state": "MO",
            "postal_code": "651092056",
            "telephone_number": "573-635-6193"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOESSEN",
        "first_name": "CALI",
        "middle_name": "INEZ",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-11-22",
        "last_updated": "2018-11-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "MO",
            "license": "2018037318",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jefferson City, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 22, 2018; 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.