Individual provider Active NPI

Cynchelle Boston

  • Family Nurse Practitioner
  • Fairborn, OH
National Provider Identifier
1376229930
Registry record updated Jul 17, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APRN.CNP.0033701 Issued in OH
Practice address
1161 E Dayton Yellow Springs Rd
Fairborn, OH 45324-6325
Phone
(937) 318-3900
NPI assigned
Jun 27, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 17, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X APRN.CNP.0033701 OH Primary

Addresses

Primary practice location

1161 E Dayton Yellow Springs Rd
Fairborn, OH 45324-6325

Mailing address

2620 Elm Hill Pike
Nashville, TN 37214-3108

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230719002764 OH Practitioner - Nurse Practitioner 0143680314 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
The Little Clinic of Ohio LLCGroup PAC ID 7719087584, 212 clinicians

Practice addresses (Care Compare)

1161 E Dayton Yellow Springs Rd
Fairborn, OH 45324-6325
Phone (937) 318-3930

Merit-based Incentive Payment System (MIPS)

Final score
86.78 of 100Reported as group
Quality
71.59
Promoting interoperability
100
Improvement activities
40
Cost
84.34

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
The Little Clinic of Ohio LLC Family CurrentSince Jul 14, 2023 Accepting new patients

Locations

199 Graceland Blvd
Columbus, OH 43214
Phone (614) 410-2814

1161 E Dayton Yellow Springs Rd
Fairborn, OH 45324
Phone (937) 318-3920

Interoperability endpoints

  • Direct secure messaging: cynchelle.boston@krogerhealth.eclinicaldirectplus.com

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": "1687824000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689552000000",
    "number": "1376229930",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2620 ELM HILL PIKE",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372143108"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1161 E DAYTON YELLOW SPRINGS RD",
            "city": "FAIRBORN",
            "state": "OH",
            "postal_code": "453246325",
            "telephone_number": "937-318-3900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOSTON",
        "first_name": "CYNCHELLE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-06-27",
        "last_updated": "2023-07-17",
        "certification_date": "2023-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OH",
            "license": "APRN.CNP.0033701",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairborn, OH

Sources for this page

Verify at the official NPI Registry.