Boundless Health, Inc.

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

Legal business name

BOUNDLESS HEALTH, INC.

Practice address

445 E Dublin Granville Rd
Worthington, OH 43085

Phone

(614) 844-3800

NPI assigned

Jan 8, 2021

Organization subpart

No

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

Authorized official

Name

Derrick Young

Title

Contracting Credentialing Manager

Phone

(614) 844-2124

Specialties & licenses 2

Addresses

Other names 1

• Boundless Behavioral Health, Inc. Former legal business name

Medicare fee-for-service enrollment

Enrolled in OH

Enrollment records 1

Other NPIs on the same Medicare enrollment 3

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• Boundless Health, Inc.

  • Community/Behavioral Health Agency
  • Worthington, OH
  • NPI 1376506469

  O20040922000682

  Same enrollment
• Boundless Health, Inc.

  • Primary Care Clinic/Center
  • West Carrollton, OH
  • NPI 1447739339

  O20040922000682

  Same enrollment
• Boundless Health, Inc.

  • General Practice Dentistry
  • Worthington, OH
  • NPI 1710575360

  O20040922000682

  Same enrollment

Tax ID family

Boundless Behavioral Health Inc5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

Organizations that report the same tax identification number in the National Provider Directory.

• Boundless Behavioral Health, Inc.

  • In Home Supportive Care Agency
  • Worthington, OH
  • NPI 1750987186
  NPD tax ID
• Boundless Behavioral Health, Inc.

  • Rehabilitation Clinic/Center
  • Worthington, OH
  • NPI 1982852299
  NPD tax ID
• Boundless Health, Inc.

  • Primary Care Clinic/Center
  • West Carrollton, OH
  • NPI 1447739339
  NPD tax ID
• Boundless Health, Inc.

  • General Practice Dentistry
  • Worthington, OH
  • NPI 1710575360
  NPD tax ID

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Sheila Victoria Canini, CNP

  • Family Nurse Practitioner
  • Columbus, OH
  • NPI 1376783308
  NPD
• Hannah Marie Popovec, M.A., CCC-SLP

  • Speech-Language Pathologist
  • Worthington, OH
  • NPI 1871184283
  NPD
• Jane Kathryn Stahl, CF, CCC-SLP

  • Speech-Language Pathologist
  • Worthington, OH
  • NPI 1376218362
  NPD

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

{
    "created_epoch": "1610064000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1634688000000",
    "number": "1346838992",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "445 E DUBLIN GRANVILLE RD",
            "city": "WORTHINGTON",
            "state": "OH",
            "postal_code": "43085",
            "telephone_number": "614-844-3800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "445 E DUBLIN GRANVILLE RD",
            "city": "WORTHINGTON",
            "state": "OH",
            "postal_code": "43085",
            "telephone_number": "614-844-3800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BOUNDLESS HEALTH, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-01-08",
        "last_updated": "2021-10-20",
        "certification_date": "2021-10-20",
        "status": "A",
        "authorized_official_last_name": "YOUNG",
        "authorized_official_first_name": "DERRICK",
        "authorized_official_title_or_position": "CONTRACTING CREDENTIALING MANAGER",
        "authorized_official_telephone_number": "614-844-2124"
    },
    "taxonomies": [
        {
            "code": "2080P0006X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics, Developmental - Behavioral Pediatrics",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Boundless Behavioral Health, Inc.",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

• Kimberlee Booker
• Boomers Medical Equipment, LLC
• Tameka Bosley
• Boundless Behavioral Health, Inc.
• Boundless Behavioral Health, Inc.
• Boundless Health, Inc.
• Boundless Health, Inc.
• Susan Kay Bourquard, LPC
• Lily Bower
• Diana Bowers, PHD, RN, RD

• General Practice Physician in Worthington, OH
• Providers in Worthington, OH by specialty
• General Practice Physician in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.