Active NPI
Michael James Boyer
- Pediatrics Physician
- Silverdale, WA
National Provider Identifier
1457385692
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- MD00014861
- Practice address
- 9951 Mickelberry Rd NW
Kitsap Childrens Clinic LLP
Silverdale, WA 98383-8309 - Phone
- (360) 692-9362
- Fax
- (360) 692-6214
- NPI assigned
- Jul 11, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | MD00014861 | WA | Primary |
Addresses
Primary practice location
9951 Mickelberry Rd NW
Kitsap Childrens Clinic LLP
Silverdale, WA 98383-8309
Mailing address
9951 Mickelberry Rd NW
Ste 101
Silverdale, WA 98383-8309
Phone (360) 692-9362
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1184506 | Medicaid | WA | |
| MD00014861 | Other | WA | MD LICENSE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MD00014861 | WA | MD | Pediatrics Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1152576000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1678147200000",
"number": "1457385692",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9951 MICKELBERRY RD NW",
"address_2": "STE 101",
"city": "SILVERDALE",
"state": "WA",
"postal_code": "983838309",
"telephone_number": "360-692-9362",
"fax_number": "360-692-6214"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9951 MICKELBERRY RD NW",
"address_2": "KITSAP CHILDRENS CLINIC LLP",
"city": "SILVERDALE",
"state": "WA",
"postal_code": "983838309",
"telephone_number": "360-692-9362",
"fax_number": "360-692-6214"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BOYER",
"first_name": "MICHAEL",
"middle_name": "JAMES",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-11",
"last_updated": "2023-03-07",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "WA",
"license": "MD00014861",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1184506",
"state": "WA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MD LICENSE",
"identifier": "MD00014861",
"state": "WA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Silverdale, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.