Karin N Boehm, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

12314T Issued in CA

Practice address

6880 Palm Ave
Sebastopol, CA 95472-4270

Phone

(707) 823-7628

Fax

(707) 823-1581

NPI assigned

Jul 1, 2005

Last updated

Oct 5, 2010By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Karin N King Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• R. David Jones, O.D.

  dba Empire Optometry

  • Optometrist
  • Santa Rosa, CA
  • NPI 1376771808
  NPD (past)
• Tiffany Moore, O.D. Inc, a Professional Optometric Corporation

  dba Empire Optometry

  • Optometrist
  • Santa Rosa, CA
  • NPI 1578090981
  NPD (past)

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

{
    "created_epoch": "1120176000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1286236800000",
    "number": "1689671976",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6880 PALM AVE",
            "city": "SEBASTOPOL",
            "state": "CA",
            "postal_code": "954724270",
            "telephone_number": "707-823-7628",
            "fax_number": "707-823-1581"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6880 PALM AVE",
            "city": "SEBASTOPOL",
            "state": "CA",
            "postal_code": "954724270",
            "telephone_number": "707-823-7628",
            "fax_number": "707-823-1581"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOEHM",
        "first_name": "KARIN",
        "middle_name": "N",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-07-01",
        "last_updated": "2010-10-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "12314T",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "SD0123140",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KARIN",
            "last_name": "KING",
            "middle_name": "N",
            "credential": "OD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Heather Bird, L.AC.
• Misty Renae Black, PTA
• John Thomas Blount, D.D.S.
• Gretchen Linda Carol Blum
• Tina Boaz, MS-CCC-SLP
• Bohemian Concierge Care
• Jerry Michael Bolduan, MD
• Michael Thomas Bollinger, M.D.
• Angel Booth, CMT
• Michele D. Borgeson, MD

• Optometrist in Sebastopol, CA
• Providers in Sebastopol, CA by specialty
• Optometrist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2010; 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.