Timothy M Boehm, M.D.

Primary specialty

Endocrinology, Diabetes & Metabolism PhysicianTaxonomy code 207RE0101X

License

R4092 Issued in AR

Practice address

10001 Lile Dr
Little Rock, AR 72205-6217

Phone

(501) 227-8000

Fax

(201) 221-5850

NPI assigned

Jun 19, 2006

Last updated

Dec 17, 2014By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1150675200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1418774400000",
    "number": "1629013073",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10001 LILE DR",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722056217",
            "telephone_number": "501-227-8000",
            "fax_number": "201-221-5850"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10001 LILE DR",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722056217",
            "telephone_number": "501-227-8000",
            "fax_number": "201-221-5850"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOEHM",
        "first_name": "TIMOTHY",
        "middle_name": "M",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-19",
        "last_updated": "2014-12-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "AR",
            "license": "R4092",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "118076001",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Rebecca Erin Bodemann-McCarley, MNSC, PNP-PC
• Sarah Elizabeth Bodenhamer, PA-C
• Dana Riggs Bodenner
• Donald Bodenner, MD
• Eric Boe, D.O.
• Marianne L Boettger, RN, NP
• Shayla Bogan
• Noah Bogart
• Michael Todd Bogatch, M.D.
• Evelyn Boggs, RN

• Endocrinology, Diabetes & Metabolism Physician in Little Rock, AR
• Providers in Little Rock, AR by specialty
• Endocrinology, Diabetes & Metabolism Physician in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 2014; 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.