B R Boehmer MD PA

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

License

M6848 Issued in ID

Legal business name

B R BOEHMER MD PA

Practice address

1335 Albion Ave
Burley, ID 83318-1817

Phone

(208) 878-2271

NPI assigned

Aug 12, 2010

Organization subpart

No

Name

Dr. Bernard R Boehmer, MD PANPI 1902891484

Title

Owner

Phone

(208) 878-2271

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

• Bernard R Boehmer, MD

  • Family Medicine Physician
  • Burley, ID
  • NPI 1902891484

  ID

  Medicare reassignment Care Compare group NPD Authorized official
• Steven Boehmer, DO

  • Family Medicine Physician
  • Burley, ID
  • NPI 1336563063

  ID

  Medicare reassignment Care Compare group NPD

Medicare fee-for-service enrollment

Enrolled in ID

Enrollment records 1

Locations

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Aug 12, 2010.

{
    "created_epoch": "1281571200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1281571200000",
    "number": "1447565627",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1335 ALBION AVE",
            "city": "BURLEY",
            "state": "ID",
            "postal_code": "833181817"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1335 ALBION AVE",
            "city": "BURLEY",
            "state": "ID",
            "postal_code": "833181817",
            "telephone_number": "208-878-2271"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "B R BOEHMER MD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-08-12",
        "last_updated": "2010-08-12",
        "status": "A",
        "authorized_official_last_name": "BOEHMER",
        "authorized_official_first_name": "BERNARD",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "208-878-2271",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD PA"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "ID",
            "license": "M6848",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "002799800",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Alice K Ash, CST
• Lacie Shilo Asher, FNP-C
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• Auralcare Hearing Centers of America, LLC
• Kevin D. Banner, D.D.S.
• Melinda Michele Barboza, L.P.C
• Terry L. Barnes, L.D.
• Randalyn Barrow, LCSW
• Chase Beal

• All providers in Burley, ID
• Clinic/Center in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2010; 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.