Active NPI
Lennis K Boyer, MD
- Pediatrics Physician
- Pullman, WA
National Provider Identifier
1689657488
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- MD0027662
- Practice address
- 1205 SE Professional Mall Blvd
Suite 104
Pullman, WA 99163-5423 - Phone
- (509) 332-2605
- Fax
- (509) 334-5754
- NPI assigned
- Nov 25, 2005
- Last updated
- Jan 13, 2011
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | MD0027662 | WA | Primary |
| Pediatrics Physician | 208000000X | M5747 | ID |
Addresses
Primary practice location
1205 SE Professional Mall Blvd
Suite 104
Pullman, WA 99163-5423
Mailing address
1205 SE Professional Mall Blvd
Suite 104
Pullman, WA 99163-5423
Phone (509) 332-2605
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 Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| M5747 | ID | MD | Pediatrics Physician |
| MD0027662 | WA | MD | Pediatrics Physician |
Interoperability endpoints
- lennis.boyer@prh.gwaydirect.com
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1132876800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1294876800000",
"number": "1689657488",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1205 SE PROFESSIONAL MALL BLVD",
"address_2": "SUITE 104",
"city": "PULLMAN",
"state": "WA",
"postal_code": "991635423",
"telephone_number": "509-332-2605",
"fax_number": "509-334-5754"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1205 SE PROFESSIONAL MALL BLVD",
"address_2": "SUITE 104",
"city": "PULLMAN",
"state": "WA",
"postal_code": "991635423",
"telephone_number": "509-332-2605",
"fax_number": "509-334-5754"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BOYER",
"first_name": "LENNIS",
"middle_name": "K",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2005-11-25",
"last_updated": "2011-01-13",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "WA",
"license": "MD0027662",
"primary": true
},
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "ID",
"license": "M5747",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Pullman, WA
- Stephanie L Boone
- Boost Collaborative (Palouse Industries)
- Michelle A Bower, M.A., CCC-SLP
- Jonathan Bowman, DPT
- Jeana Boyd, LMSW
- Kristine Ellen Brenc, NP-C
- Anthony Demetris Bright, PHARMD
- Brighton Rehabilitation LLC (Brighton Rehabilitation Services)
- Brighton Rehabilitation, LLC
- Michael David Brodeur, PSY.D.
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 2011; 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.