Elwood Bernard Boone Jr., MD

Primary specialty

Urology PhysicianTaxonomy code 208800000X

License

0101020738 Issued in VA

Practice address

110 N Robinson St
Suite 403
Richmond, VA 23220

Phone

(804) 354-6202

Fax

(804) 354-0870

NPI assigned

Apr 25, 2006

Last updated

Aug 18, 2008By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Retreat Internal Medicine LLC

  • Internal Medicine Physician
  • Richmond, VA
  • NPI 1942355367
  NPD (past)
• Urology Specialists of Richmond LLC

  • Urology Physician
  • Richmond, VA
  • NPI 1568529113
  NPD (past)

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

{
    "created_epoch": "1145923200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1219017600000",
    "number": "1629034822",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 N ROBINSON ST",
            "address_2": "SUITE 403",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "23220",
            "telephone_number": "804-354-6202",
            "fax_number": "804-354-0870"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 N ROBINSON ST",
            "address_2": "SUITE 403",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "23220",
            "telephone_number": "804-354-6202",
            "fax_number": "804-354-0870"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOONE",
        "first_name": "ELWOOD",
        "middle_name": "BERNARD",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-04-25",
        "last_updated": "2008-08-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "VA",
            "license": "0101020738",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1629034822",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7556870",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Brenda Bonuccelli, LCSW
• Brooke Marie Bonzano
• Keona Booker, RRT
• Laura Anne Boomer, MD
• Chanel Boone, FNP-BC
• Jacqueline Boone, AGACNP-BC, PMHNP-BC
• Latausha Jeanell Boone, LPC, NCC
• Melanie Lynn Boone, D.D.S.
• Sharon Scott Boone, OTR L RD
• Tameka Boone

• Urology Physician in Richmond, VA
• Providers in Richmond, VA by specialty
• Urology Physician in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2008; 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.