Jennifer Erin Earl-Boehm, PHD, ATC

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

License

515-039 Issued in WI

Practice address

3409 N Downer Ave
Pavilion Suite 350
Milwaukee, WI 53211

Phone

(414) 229-3227

Fax

(414) 229-3366

NPI assigned

Mar 31, 2015

Last updated

Mar 31, 2015By 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 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

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.

• University of Wisconsin System Non Payroll

  dba UW Board of Regents UWMilwaukee Institue for Urban Health Partnerships

  • Family Nurse Practitioner
  • Milwaukee, WI
  • NPI 1295944635
  NPD (past)

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

{
    "created_epoch": "1427760000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1427760000000",
    "number": "1497140123",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 413",
            "address_2": "PAVILION SUITE 350",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532010413",
            "telephone_number": "414-229-3227",
            "fax_number": "414-229-3366"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3409 N DOWNER AVE",
            "address_2": "PAVILION SUITE 350",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "53211",
            "telephone_number": "414-229-3227",
            "fax_number": "414-229-3366"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EARL-BOEHM",
        "first_name": "JENNIFER",
        "middle_name": "ERIN",
        "name_prefix": "Dr.",
        "credential": "PHD, ATC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-03-31",
        "last_updated": "2015-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "WI",
            "license": "515-039",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Athletic Trainer in Milwaukee, WI
• Providers in Milwaukee, WI by specialty
• Athletic Trainer in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 2015; 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.