W.a. Boade, MD Prof LLC

Primary specialty

Nuclear Medicine PhysicianTaxonomy code 207U00000X

Legal business name

W.A. BOADE, MD PROF LLC

Practice address

4500 N Cliff Ave
Sioux Falls, SD 57104-0553

Phone

(605) 306-6000

Fax

(605) 221-2141

NPI assigned

Jun 27, 2007

Organization subpart

No

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

Authorized official

Name

Penny Ann Jensen

Title

Office Manager

Phone

(605) 306-6000

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1182902400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1558568378",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4500 N CLIFF AVE",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571040553",
            "telephone_number": "605-306-6000",
            "fax_number": "605-221-2141"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4500 N CLIFF AVE",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571040553",
            "telephone_number": "605-306-6000",
            "fax_number": "605-221-2141"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "W.A. BOADE, MD PROF LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-27",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "JENSEN",
        "authorized_official_first_name": "PENNY",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "605-306-6000"
    },
    "taxonomies": [
        {
            "code": "207U00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nuclear Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6600093",
            "state": "SD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Theodore G. Voss, CRNA
• Daniel Vostad, PHARM.D
• Heather Joy Vroom, PT, DPT
• Briana Vudi, PHARM.D.
• Shawn Michael Vuong, M.D.
• Amanda Waba
• Godfrey Oduor Wabwire, MD
• Stacy Wachholtz
• Katherine E Wackel, CRNA
• Deloros E Wacker, RN

• Nuclear Medicine Physician in Sioux Falls, SD
• Providers in Sioux Falls, SD by specialty
• Nuclear Medicine Physician in South Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.