Individual provider Active NPI

Karen Boheen, D.O.

  • Obstetrics & Gynecology Physician
  • Layton, UT
National Provider Identifier
1467452383
Registry record updated Oct 21, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
99-370139-1204 Issued in UT
Practice address
1492 W Antelope Dr
#205
Layton, UT 84041-1139
Phone
(801) 728-0600
Fax
(801) 728-0606
NPI assigned
Jul 21, 2005
Reactivated
Apr 7, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 21, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X DO01389 RI
Obstetrics & Gynecology Physician 207V00000X 99-370139-1204 UT Primary

Addresses

Primary practice location

1492 W Antelope Dr
#205
Layton, UT 84041-1139

Mailing address

1492 W Antelope Dr
#205
Layton, UT 84041-1139
Phone (801) 728-0600

Other practice location 1

20 Powell Ave
Newport, RI 02840
Phone (401) 848-5556

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT, RI2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20040105000036 UT Practitioner - Obstetrics/Gynecology 6507765088 Reassigns benefits to 1 organization
I20241031002867 RI Practitioner - Obstetrics/Gynecology 6507765088 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Other, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Tanner Memorial ClinicGroup PAC ID 4284547985, 251 clinicians

Practice addresses (Care Compare)

1477 N 2000
Suite C
Clinton, UT 84015-9099
Phone (801) 773-4840

2121 N 1700
Layton, UT 84041-8803
Phone (801) 773-4840

425 S 100
Layton, UT 84041-5356
Phone (801) 773-4840

Hospital & facility affiliations

  • Holy Cross Hospital-Davis Hospital, Layton, UT, CCN 460041

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of the uterus1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy, Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
DO01389RIMDObstetrics & Gynecology Physician
99-370139-1204UTMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Lifespan Physician Group, Inc. Obstetrics & Gynecology CurrentSince Dec 1, 2024 Accepting new patients
Tanner Memorial Clinic Obstetrics & Gynecology Current Accepting new patients
Lifespan Physician Group, Inc. CurrentSince Dec 1, 2024 Accepting new patients
Tanner Memorial Clinic CurrentSince Sep 1, 2023 Accepting new patients
Lifespan Corporation Current Accepting new patients
Tanner Memorial Clinic CurrentSince Sep 1, 2023 Accepting new patients

Locations

185A High Service Ave
North Providence, RI 02904
Phone (401) 354-6050

117 Ellenfield St
Ste 101
Providence, RI 02905
Phone (401) 444-4318

425 S 100 W
Layton, UT 84041
Phone (801) 682-8708

2132 N Robins Dr
Ste 310
Layton, UT 84041

Interoperability endpoints

  • Direct secure messaging: karen.boheen.p1@direct.tannerclinic.nextgenshare.com
  • Direct secure messaging: kboheen229912@brownhealth.medalliesdirect.net

Organizations & group practices 6

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1121904000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729468800000",
    "number": "1467452383",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1492 W ANTELOPE DR",
            "address_2": "#205",
            "city": "LAYTON",
            "state": "UT",
            "postal_code": "840411139",
            "telephone_number": "801-728-0600",
            "fax_number": "801-728-0606"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1492 W ANTELOPE DR",
            "address_2": "#205",
            "city": "LAYTON",
            "state": "UT",
            "postal_code": "840411139",
            "telephone_number": "801-728-0600",
            "fax_number": "801-728-0606"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "20 Powell Ave",
            "address_purpose": "LOCATION",
            "city": "Newport",
            "state": "RI",
            "postal_code": "02840",
            "country_code": "US",
            "telephone_number": "401-848-5556",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BOHEEN",
        "first_name": "KAREN",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-07-21",
        "last_updated": "2024-10-21",
        "certification_date": "2024-10-16",
        "deactivation_date": "2006-03-21",
        "reactivation_date": "2006-04-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "RI",
            "license": "DO01389",
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "UT",
            "license": "99-370139-1204",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Layton, UT

Sources for this page

Verify at the official NPI Registry.