Active NPI
Kathryn Amanda Boehmer
- Physician Assistant
- Columbus, OH
National Provider Identifier
1366141772
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 50.008193RX
- Practice address
- 3535 Olentangy River Rd
Columbus, OH 43214-3998 - Phone
- (614) 566-5000
- NPI assigned
- Feb 24, 2023
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Physician Assistant | 363A00000X | 50.008193RX | OH | Primary |
Addresses
Primary practice location
3535 Olentangy River Rd
Columbus, OH 43214-3998
Mailing address
4802 Inisheer CT
Dublin, OH 43017-9170
Phone (614) 795-1997
Other practice location 1
111 S Grant Ave
Columbus, OH 43215-1898
Phone (614) 566-9000
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in OH
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Organizations & group practices 1
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1677196800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1686355200000",
"number": "1366141772",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4802 INISHEER CT",
"city": "DUBLIN",
"state": "OH",
"postal_code": "430179170",
"telephone_number": "614-795-1997"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3535 OLENTANGY RIVER RD",
"city": "COLUMBUS",
"state": "OH",
"postal_code": "432143998",
"telephone_number": "614-566-5000"
}
],
"practiceLocations": [
{
"address_1": "111 S Grant Ave",
"address_purpose": "LOCATION",
"city": "Columbus",
"state": "OH",
"postal_code": "432151898",
"country_code": "US",
"telephone_number": "614-566-9000",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "BOEHMER",
"first_name": "KATHRYN",
"middle_name": "AMANDA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-02-24",
"last_updated": "2023-06-10",
"certification_date": "2023-06-10",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "OH",
"license": "50.008193RX",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Columbus, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2023; 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.