Melissa Boerema, D.D.S

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

2010017989 Issued in MO

Practice address

205 E Dakota St
Butler, MO 64730-2113

Phone

(844) 853-8937

NPI assigned

Mar 29, 2011

Last updated

Oct 20, 2022By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in MO

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Compass Health, Inc

  dba Compass Health Network

  • Community/Behavioral Health Agency
  • Clinton, MO
  • NPI 1285619494
  Medicare reassignment NPD
• Compass Health, Inc

  • Federally Qualified Health Center (FQHC)
  • Rolla, MO
  • NPI 1558258632
  NPD
• Arbor Creek Dental PA

  • Dentist
  • Olathe, KS
  • NPI 1508042680
  NPD (past)

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

{
    "created_epoch": "1301356800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1666224000000",
    "number": "1457640641",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1800 COMMUNITY",
            "city": "CLINTON",
            "state": "MO",
            "postal_code": "647358804",
            "telephone_number": "660-885-8131"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "205 E DAKOTA ST",
            "city": "BUTLER",
            "state": "MO",
            "postal_code": "647302113",
            "telephone_number": "844-853-8937"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1800 Community",
            "address_purpose": "LOCATION",
            "city": "Clinton",
            "state": "MO",
            "postal_code": "647358804",
            "country_code": "US",
            "telephone_number": "844-853-8937",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "501 N Sunset Ln",
            "address_purpose": "LOCATION",
            "city": "Raymore",
            "state": "MO",
            "postal_code": "640839402",
            "country_code": "US",
            "telephone_number": "844-853-8937",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "101 Hospital Dr",
            "address_purpose": "LOCATION",
            "city": "Osceola",
            "state": "MO",
            "postal_code": "647769547",
            "country_code": "US",
            "telephone_number": "844-853-8937",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "107 Broadway Street",
            "address_purpose": "LOCATION",
            "city": "El Dorado Springs",
            "state": "MO",
            "postal_code": "647441133",
            "country_code": "US",
            "telephone_number": "844-853-8937",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "301 W Austin Blvd",
            "address_purpose": "LOCATION",
            "city": "Nevada",
            "state": "MO",
            "postal_code": "647723124",
            "country_code": "US",
            "telephone_number": "844-853-8937",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2000 N Gaines Dr",
            "address_purpose": "LOCATION",
            "city": "Clinton",
            "state": "MO",
            "postal_code": "647351132",
            "country_code": "US",
            "telephone_number": "448-538-9378",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BOEREMA",
        "first_name": "MELISSA",
        "name_prefix": "Dr.",
        "credential": "D.D.S",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-03-29",
        "last_updated": "2022-10-20",
        "certification_date": "2022-10-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "KS",
            "license": "61142",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MO",
            "license": "2010017989",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bates County Memorial Hospital Ambulance
• Bates County Memorial Hospital Pharmacy
• Michelle R. Bearce, PLPC
• Jeffrey W Bissing, D.O.
• Body Beautiful
• Timothy Brannon, CRNA
• Breezy Meadows, LLC
• Breezy Operations LLC (Butler Center for Rehabilitation and Healthcare)
• Miranda Leigh Bridges, LPC
• Bristol Care, Inc.

• General Practice Dentistry in Butler, MO
• Providers in Butler, MO by specialty
• General Practice Dentistry in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 2022; 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.