Advanced Womens Healthcare Center, LLC

Primary specialty

Gynecology PhysicianTaxonomy code 207VG0400X

License

31521-020 Issued in WI

Legal business name

ADVANCED WOMENS HEALTHCARE CENTER, LLC

Practice address

933 Newbury St
Suite 102
Ripon, WI 54971-1730

Phone

(920) 748-0550

Fax

(920) 748-0555

NPI assigned

Aug 10, 2007

Last updated

Dec 31, 2007By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Paul Boeder, MD

Title

Physician/Owner

Phone

(920) 748-0550

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1186704000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1199059200000",
    "number": "1669664926",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "933 NEWBURY ST",
            "address_2": "SUITE 102",
            "city": "RIPON",
            "state": "WI",
            "postal_code": "549711730",
            "telephone_number": "920-748-0550",
            "fax_number": "920-748-0555"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "933 NEWBURY ST",
            "address_2": "SUITE 102",
            "city": "RIPON",
            "state": "WI",
            "postal_code": "549711730",
            "telephone_number": "920-748-0550",
            "fax_number": "920-748-0555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVANCED WOMENS HEALTHCARE CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-08-10",
        "last_updated": "2007-12-31",
        "status": "A",
        "authorized_official_last_name": "BOEDER",
        "authorized_official_first_name": "PAUL",
        "authorized_official_title_or_position": "PHYSICIAN/OWNER",
        "authorized_official_telephone_number": "920-748-0550",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207VG0400X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Gynecology",
            "state": "WI",
            "license": "31521-020",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jerilyn R Abba
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• Gynecology Physician in Ripon, WI
• Providers in Ripon, WI by specialty
• Gynecology Physician in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 31, 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.