Individual provider Active NPI

Benjamin Boerner

  • Family Nurse Practitioner
  • Dublin, OH
National Provider Identifier
1568089043
Registry record updated Sep 23, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
0027182 Issued in OH
Practice address
6565 Perimeter Dr
Dublin, OH 43016-8461
Phone
(740) 304-0151
NPI assigned
Jun 30, 2020
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 23, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Registered Nurse 163WG0000X 409226 OH
Family Nurse Practitioner 363LF0000X 0027182 OH Primary

Addresses

Primary practice location

6565 Perimeter Dr
Dublin, OH 43016-8461

Mailing address

410 W 10TH Ave
Columbus, OH 43210-1240

Other practice location 1

410 W 10th Ave
Columbus, OH 43210-1240
Phone (614) 293-8000

Other identifiers 1

IdentifierTypeStateIssuer
APRNCNP0027182OtherOHLICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230125000929 OH Practitioner - Nurse Practitioner 4688045909 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Premier Allergy and Asthma IncGroup PAC ID 0840512547, 12 clinicians

Practice addresses (Care Compare)

1015 W 5TH Ave
Columbus, OH 43212-2637
Phone (614) 328-9927

16900 Square Dr
Suite 104
Marysville, OH 43040-8948
Phone (614) 328-9927

6565 Perimeter Dr
Dublin, OH 43016-8461
Phone (614) 328-9927

7100 Graphics Way
Suite 2300
Lewis Center, OH 43035-1123
Phone (614) 328-9927

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
409226OHMDGeneral Practice Registered Nurse
0027182OHMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Premier Allergy and Asthma Inc CurrentSince Dec 3, 2022 Accepting new patients
Premier Allergy CurrentSince Sep 27, 2020 Accepting new patients

Locations

6390 Gender Rd
Canal Winchester, OH 43110

1015 W 5th Ave
Columbus, OH 43212

6565 Perimeter Dr
Dublin, OH 43016
Phone (740) 304-0151

5500 N Meadows Dr
Ste 110
Grove City, OH 43123

4343 All Seasons Dr
Ste 240
Hilliard, OH 43026
Phone (614) 544-1460

2405 N Columbus St
Ste 270
Lancaster, OH 43130
Phone (740) 653-5494

7100 Graphics Way
Ste 2300
Lewis Center, OH 43035
Phone (380) 898-5561

153 W Main St
Ste 102
New Albany, OH 43054
Phone (614) 855-6999

110 Polaris Pkwy
Ste 325
Westerville, OH 43082
Phone (614) 218-4177

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1593475200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600819200000",
    "number": "1568089043",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "410 W 10TH AVE",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432101240"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6565 PERIMETER DR",
            "city": "DUBLIN",
            "state": "OH",
            "postal_code": "430168461",
            "telephone_number": "740-304-0151"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "410 W 10th Ave",
            "address_purpose": "LOCATION",
            "city": "Columbus",
            "state": "OH",
            "postal_code": "432101240",
            "country_code": "US",
            "telephone_number": "614-293-8000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BOERNER",
        "first_name": "BENJAMIN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-06-30",
        "last_updated": "2020-09-23",
        "certification_date": "2020-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WG0000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, General Practice",
            "state": "OH",
            "license": "409226",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OH",
            "license": "0027182",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "APRNCNP0027182",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dublin, OH

Sources for this page

Verify at the official NPI Registry.