Boulevard Dermatology P a

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

Legal business name

BOULEVARD DERMATOLOGY P A

Practice address

5520 College Blvd
Suite 410
Overland Park, KS 66211-1630

Phone

(913) 451-5934

Fax

(913) 451-4716

NPI assigned

Mar 29, 2007

Organization subpart

No

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

Authorized official

Name

Jana Kay Wood

Title

Director of Operations

Phone

(816) 318-9400

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1175126400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1197331200000",
    "number": "1598885295",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5520 COLLEGE BLVD",
            "address_2": "SUITE 410",
            "city": "OVERLAND PARK",
            "state": "KS",
            "postal_code": "662111630",
            "telephone_number": "913-451-5934",
            "fax_number": "913-451-4716"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5520 COLLEGE BLVD",
            "address_2": "SUITE 410",
            "city": "OVERLAND PARK",
            "state": "KS",
            "postal_code": "662111630",
            "telephone_number": "913-451-5934",
            "fax_number": "913-451-4716"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BOULEVARD DERMATOLOGY P A",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-29",
        "last_updated": "2007-12-11",
        "status": "A",
        "authorized_official_last_name": "WOOD",
        "authorized_official_first_name": "JANA",
        "authorized_official_middle_name": "KAY",
        "authorized_official_title_or_position": "DIRECTOR OF OPERATIONS",
        "authorized_official_telephone_number": "816-318-9400"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rachael Marie Boston, PTA
• Larry D Botts, M.D.
• Sarah Boucher, RPT
• Victoria L Bouckhout, P.T.
• Lisa Jo Boudrieau, PT
• Boulevard Internal Medicine
• Boulevard Psychology, LLC
• Sarah Boulton
• Brian Wayne Bounds, MPT, ATC, CSCS
• Heather Lynn Bourdon, D.C.

• Dermatology Physician in Overland Park, KS
• Providers in Overland Park, KS by specialty
• Dermatology Physician in Kansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2007; 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.