Colette Poole-Boykin, M.D

Primary specialty

Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X

Practice address

2200 Bergquist Dr Ste 1
Ste 1
Lackland Afb, TX 78236-9908

Phone

(210) 916-8687

NPI assigned

Apr 6, 2015

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

Credentials

Doctor of Medicine

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

{
    "created_epoch": "1428278400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1428451200000",
    "number": "1376938399",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2200 BERGQUIST DR STE 1",
            "address_2": "STE 1",
            "city": "LACKLAND AFB",
            "state": "TX",
            "postal_code": "782369908"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2200 BERGQUIST DR STE 1",
            "address_2": "STE 1",
            "city": "LACKLAND AFB",
            "state": "TX",
            "postal_code": "782369908",
            "telephone_number": "210-916-8687"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POOLE-BOYKIN",
        "first_name": "COLETTE",
        "name_prefix": "Dr.",
        "credential": "M.D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-04-06",
        "last_updated": "2015-04-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brian Penton, DDS
• Curtis M Perz
• Judy A Peterson, R.PH., M.S.
• Hunter H Phillips, MD
• James Matson Piper II, DMD
• Casey Pritchett, IDMT
• Nicole Heather Raney, PT, DSC, FAAOMPT
• Richard V Ray, PA-C
• Sylvie Byaombe Rehani, PHARM.D.
• Regina Maria Reinsvold, M.D.

• Student in an Organized Health Care Education/Training Program in Lackland Afb, TX
• Providers in Lackland Afb, TX by specialty
• Student in an Organized Health Care Education/Training Program in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 2015; 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.