Individual provider Active NPI

Renee A. Boehrns, PA-C

  • Physician Assistant
  • Yankton, SD
National Provider Identifier
1689700577
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
0440 Issued in SD
Practice address
3515 Broadway Ave
Yankton, SD 57078-4917
Phone
(605) 668-3100
Fax
(605) 668-3460
NPI assigned
Feb 26, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 0440 SD Primary

Addresses

Primary practice location

3515 Broadway Ave
Yankton, SD 57078-4917

Mailing address

29945 448TH Ave
Volin, SD 57072-5713
Phone (605) 263-2076

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SD
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101012001038 SD Practitioner - Physician Assistant 2567654361 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
State of South Dakota CurrentSince Sep 18, 2008 Accepting new patients

Locations

500 E Capitol Ave
#212
Pierre, SD 57501

3515 Broadway Ave
Yankton, SD 57078
Phone (605) 668-3100

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1172448000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1689700577",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "29945 448TH AVE",
            "city": "VOLIN",
            "state": "SD",
            "postal_code": "570725713",
            "telephone_number": "605-263-2076"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3515 BROADWAY AVE",
            "city": "YANKTON",
            "state": "SD",
            "postal_code": "570784917",
            "telephone_number": "605-668-3100",
            "fax_number": "605-668-3460"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOEHRNS",
        "first_name": "RENEE",
        "middle_name": "A.",
        "name_prefix": "Ms.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-26",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "SD",
            "license": "0440",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Yankton, SD

Sources for this page

Verify at the official NPI Registry.