Jerry C Bouman DO PC Inc

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

License

0524097 Issued in KS

Legal business name

JERRY C BOUMAN DO PC INC

Practice address

1902 S US Highway 59
Parsons, KS 67357-4948

Phone

(620) 423-1606

Fax

(620) 423-1668

NPI assigned

Jan 16, 2009

Organization subpart

No

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

Authorized official

Name

Dr. Jerry Craig Bouman, DO

Title

Owner

Phone

(620) 423-1606

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1232064000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1238630400000",
    "number": "1598902223",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1902 S HWY 59 BLDG D",
            "city": "PARSONS",
            "state": "KS",
            "postal_code": "673574955",
            "telephone_number": "620-423-1606",
            "fax_number": "620-423-1668"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1902 S US HIGHWAY 59",
            "city": "PARSONS",
            "state": "KS",
            "postal_code": "673574948",
            "telephone_number": "620-423-1606",
            "fax_number": "620-423-1668"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JERRY C BOUMAN DO PC INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-01-16",
        "last_updated": "2009-04-02",
        "status": "A",
        "authorized_official_last_name": "BOUMAN",
        "authorized_official_first_name": "JERRY",
        "authorized_official_middle_name": "CRAIG",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "620-423-1606",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "KS",
            "license": "0524097",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Auriana Danielle Jackson, CPHT
• Devendra K Jain, M.D.
• Reno Q Jain, R.D/L.D
• Kylie N Jenkins, LMSW
• Shannon Jerred
• John P Lakin DC PA
• John P Lakin DC PA
• Kevin M Kabrey, CPTA
• Kansas City Vamc
• Tishsa Renee Karhoff

• Ambulatory Surgical Clinic/Center in Parsons, KS
• Providers in Parsons, KS by specialty
• Ambulatory Surgical Clinic/Center in Kansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 2009; 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.