Kamera Sakeena Boggon, AGNP -C

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

4704248431 Issued in MI

Practice address

6309 Mack Ave
Detroit, MI 48207-2302

Phone

(313) 478-6204

NPI assigned

Mar 17, 2016

Last updated

Jun 14, 2024By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kboggon498948@direct.hfhs.org

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.

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  Medicare reassignment NPD
• Downriver Mental Health Clinic PC

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• New Life Alternatives LLC

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  • NPI 1033759659

  Single Specialty

  NPD (past)
• Paragon Clinical Midwest, LLC

  • Nurse Practitioner
  • Merrillville, IN
  • NPI 1619335700

  Single Specialty

  NPD (past)

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

{
    "created_epoch": "1458172800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718323200000",
    "number": "1700247772",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6309 MACK AVE",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482072302",
            "telephone_number": "313-478-6204"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6309 MACK AVE",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482072302",
            "telephone_number": "313-478-6204"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "22355 W. 8 mile rd",
            "address_purpose": "LOCATION",
            "city": "Detroit",
            "state": "MI",
            "postal_code": "48219",
            "country_code": "US",
            "telephone_number": "313-255-6450 x128",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BOGGON",
        "first_name": "KAMERA",
        "middle_name": "SAKEENA",
        "credential": "AGNP -C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-03-17",
        "last_updated": "2024-06-14",
        "certification_date": "2024-06-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "MI",
            "license": "4704248431",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MI",
            "license": "704248431",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MI",
            "license": "4704248431",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Andrew Boeve
• Elias Sileshi Bogale, MD
• Brittany Bogan, MD
• Nancy Bogdan, LPC
• Cassandra Boggon
• Jamie Boggs, MD
• Relaina Denise Bogins, LBSW, MSW,CAADC
• Rhiannon Marie-Heckel Boguszewicz, NP
• Emily Boguth, MA, CCC-SLP
• Latoya Bohana

• Psychiatric/Mental Health Nurse Practitioner in Detroit, MI
• Providers in Detroit, MI by specialty
• Psychiatric/Mental Health Nurse Practitioner in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 2024; 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.

Verify at the official NPI Registry.