John R Boardman, MD

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

27561 Issued in WI

Practice address

2629 N 7TH St
Sheboygan, WI 53083-4932

Phone

(920) 451-5553

Fax

(920) 451-5113

NPI assigned

Jun 28, 2006

Last updated

Aug 26, 2008By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1151452800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1219708800000",
    "number": "1487682696",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2629 N 7TH ST",
            "city": "SHEBOYGAN",
            "state": "WI",
            "postal_code": "530834932",
            "telephone_number": "920-451-5553",
            "fax_number": "920-451-5113"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2629 N 7TH ST",
            "city": "SHEBOYGAN",
            "state": "WI",
            "postal_code": "530834932",
            "telephone_number": "920-451-5553",
            "fax_number": "920-451-5113"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOARDMAN",
        "first_name": "JOHN",
        "middle_name": "R",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-28",
        "last_updated": "2008-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "WI",
            "license": "27561",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30735200",
            "state": "WI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "104363050",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD",
            "identifier": "930111410",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Krishna K. Bobbili, MD
• Boehmer Wellness SC
• Julaine Marie Boening, OTR
• Dana Boerner-Mai, RDH
• James Bohren

• Emergency Medicine Physician in Sheboygan, WI
• Providers in Sheboygan, WI by specialty
• Emergency Medicine Physician in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2008; 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.