Active NPI
Ralph O Boling Jr., D.O.
- Obstetrics & Gynecology Physician
- Kirksville, MO
National Provider Identifier
1659356699
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Obstetrics & Gynecology Physician
- License
- R4G47
- Practice address
- 1605 South Baltimore Street
Suite B
Kirksville, MO 63501 - Phone
- (660) 956-7279
- Fax
- (660) 665-3570
- NPI assigned
- Dec 13, 2005
- Last updated
- Nov 1, 2021
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Obstetrics & Gynecology Physician | 207V00000X | R4G47 | MO | Primary |
Addresses
Primary practice location
1605 South Baltimore Street
Suite B
Kirksville, MO 63501
Mailing address
1605 South Baltimore Street
Suite B
Kirksville, MO 63501
Phone (660) 956-7279
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1659356699 | Medicaid | MO |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: Yes
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Ozarks Medical Center | Past | Accepting new patients |
Organizations & group practices 1
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.
-
dba Ozarks Healthcare
- General Acute Care Hospital
- West Plains, MO
- NPI 1831115641
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1134432000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1635724800000",
"number": "1659356699",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1605 SOUTH BALTIMORE STREET",
"address_2": "SUITE B",
"city": "KIRKSVILLE",
"state": "MO",
"postal_code": "63501",
"telephone_number": "660-956-7279",
"fax_number": "660-665-3570"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1605 SOUTH BALTIMORE STREET",
"address_2": "SUITE B",
"city": "KIRKSVILLE",
"state": "MO",
"postal_code": "63501",
"telephone_number": "660-956-7279",
"fax_number": "660-665-3570"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BOLING",
"first_name": "RALPH",
"middle_name": "O",
"name_prefix": "Mr.",
"name_suffix": "Jr.",
"credential": "D.O.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2005-12-13",
"last_updated": "2021-11-01",
"certification_date": "2021-11-01",
"status": "A"
},
"taxonomies": [
{
"code": "207V00000X",
"taxonomy_group": "",
"desc": "Obstetrics & Gynecology",
"state": "MO",
"license": "R4G47",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1659356699",
"state": "MO"
}
],
"endpoints": [],
"other_names": []
}Other providers in Kirksville, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.