Phyllis Diane Boone, N.P.

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

4704108827 Issued in MI

Practice address

3600 E Fulton
Grand Rapids, MI 49546-1322

Phone

(616) 949-4971

NPI assigned

Oct 18, 2011

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

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

{
    "created_epoch": "1318896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1318896000000",
    "number": "1477838845",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3140",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495013140",
            "telephone_number": "616-459-0898",
            "fax_number": "616-459-6963"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3600 E FULTON",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495461322",
            "telephone_number": "616-949-4971"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOONE",
        "first_name": "PHYLLIS",
        "middle_name": "DIANE",
        "credential": "N.P.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-10-18",
        "last_updated": "2011-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MI",
            "license": "4704108827",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Janna Marie Boomstra, M.A., CCC-SLP
• Sarah Boomstra, NP
• Sheri Lyn Boon, RN
• Alicia Anne Boone, DO
• David A Boone, D.D.S.
• Allison Boonie, NP-C
• Emma Boonstra
• Leslie A Boonstra, PA-C
• Patricia Boonstra, MSW
• Christine Boorsma, RN

• Nurse Practitioner in Grand Rapids, MI
• Providers in Grand Rapids, MI by specialty
• Nurse Practitioner in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.