Active NPI
Rebecca Nicole Boan, M.S., R.D., L.D.
- Metabolic Nutrition Registered Dietitian
- Leawood, KS
National Provider Identifier
1669817292
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Metabolic Nutrition Registered Dietitian
- License
- 1775
- Practice address
- 4963 W 135TH St
Leawood, KS 66224-6901 - Phone
- (913) 814-8222
- NPI assigned
- May 9, 2013
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Metabolic Nutrition Registered Dietitian | 133VN1006X | 1775 | KS | Primary |
Addresses
Primary practice location
4963 W 135TH St
Leawood, KS 66224-6901
Mailing address
15583 Ballentine St
Overland Park, KS 66221-9785
Phone (913) 669-0708
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1775 | KS | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1368057600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1411344000000",
"number": "1669817292",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "15583 BALLENTINE ST",
"city": "OVERLAND PARK",
"state": "KS",
"postal_code": "662219785",
"telephone_number": "913-669-0708"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4963 W 135TH ST",
"city": "LEAWOOD",
"state": "KS",
"postal_code": "662246901",
"telephone_number": "913-814-8222"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BOAN",
"first_name": "REBECCA",
"middle_name": "NICOLE",
"name_prefix": "Miss",
"credential": "M.S., R.D., L.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2013-05-09",
"last_updated": "2014-09-22",
"status": "A"
},
"taxonomies": [
{
"code": "133VN1006X",
"taxonomy_group": "",
"desc": "Dietitian, Registered, Nutrition, Metabolic",
"state": "KS",
"license": "1775",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Leawood, KS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 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.