Individual provider Active NPI

Christine Marie Boylan, M.D.

  • Family Medicine Physician
  • Overland Park, KS
National Provider Identifier
1568413557
Registry record updated Dec 29, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
04-25087 Issued in KS
Practice address
5701 W 119TH St
Overland Park, KS 66209-3722
Phone
(913) 647-4325
Fax
(913) 647-4331
NPI assigned
May 13, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 29, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 04-25087 KS Primary

Addresses

Primary practice location

5701 W 119TH St
Overland Park, KS 66209-3722

Mailing address

5701 W 119TH St
Overland Park, KS 66209-3721
Phone (913) 647-4325

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190409001306 WI Practitioner - Family Practice 1254320013 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
04-25087KSMDFamily Medicine Physician
20219KYMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
MCHS Hospitals Inc CurrentSince Apr 1, 2019 Accepting new patients
Marshfield Clinic Inc CurrentSince Apr 1, 2019 Accepting new patients
MCHS Hospitals Inc CurrentSince Apr 1, 2019 Accepting new patients
Town Plaza Family Practice LLC Family Medicine Past Accepting new patients
University of Cincinnati Physicians Company, LLC Family Medicine Past Accepting new patients

Locations

1000 Starr Ave
Eau Claire, WI 54703
Phone (715) 858-4850

3501 Golf Rd
Eau Claire, WI 54701
Phone (715) 858-4200

1000 N Oak Ave
Marshfield, WI 54449
Phone (715) 387-5111

Organizations & group practices 5

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": "1147478400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1293580800000",
    "number": "1568413557",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5701 W 119TH ST",
            "city": "OVERLAND PARK",
            "state": "KS",
            "postal_code": "662093721",
            "telephone_number": "913-647-4325",
            "fax_number": "913-647-4331"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5701 W 119TH ST",
            "city": "OVERLAND PARK",
            "state": "KS",
            "postal_code": "662093722",
            "telephone_number": "913-647-4325",
            "fax_number": "913-647-4331"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOYLAN",
        "first_name": "CHRISTINE",
        "middle_name": "MARIE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-13",
        "last_updated": "2010-12-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "KS",
            "license": "04-25087",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Overland Park, KS

Sources for this page

Verify at the official NPI Registry.