Individual provider Active NPI

Dwanna Michelle Ward-Boahen, APRN

  • Family Nurse Practitioner
  • Tallahassee, FL
National Provider Identifier
1720269806
Registry record updated Jun 9, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
3415252 Issued in FL
Practice address
1775 One Healing PL
Tallahassee, FL 32308-4600
Phone
(850) 431-5360
Fax
(850) 431-5367
NPI assigned
Nov 17, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 9, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 003711 CT
Family Nurse Practitioner 363LF0000X 3415252 FL Primary

Addresses

Primary practice location

1775 One Healing PL
Tallahassee, FL 32308-4600

Mailing address

1775 One Healing PL
Tallahassee, FL 32308-4600
Phone (850) 431-5360

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20150721001984 FL Practitioner - Nurse Practitioner 4385786888 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1775 One Healing PL
Tallahassee, FL 32308-4600
Phone (850) 431-5360

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3711CTMDMedical Physician Assistant
003711CTMDFamily Nurse Practitioner
3415252FLMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Tallahassee Memorial Healthcare Inc Current Accepting new patients
Tallahassee Memorial Healthcare Inc CurrentSince Jul 1, 2015 Accepting new patients
Tallahassee Memorial Healthcare Inc CurrentSince Jul 1, 2015 Accepting new patients

Locations

15 Council Moore Rd
Crawfordville, FL 32327
Phone (850) 926-7105

555 N Byron Butler Pkwy
Perry, FL 32347
Phone (850) 431-5360

1401 Centerville Rd
Ste 400
Tallahassee, FL 32308
Phone (850) 431-3360

1775 One Healing Pl
Tallahassee, FL 32308
Phone (850) 431-4226

Interoperability endpoints

  • Direct secure messaging: dward21615@tallahasseememorial.direct-ci.com

Organizations & group practices 3

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1195257600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1433808000000",
    "number": "1720269806",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1775 ONE HEALING PL",
            "city": "TALLAHASSEE",
            "state": "FL",
            "postal_code": "323084600",
            "telephone_number": "850-431-5360",
            "fax_number": "850-431-5367"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1775 ONE HEALING PL",
            "city": "TALLAHASSEE",
            "state": "FL",
            "postal_code": "323084600",
            "telephone_number": "850-431-5360",
            "fax_number": "850-431-5367"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WARD-BOAHEN",
        "first_name": "DWANNA",
        "middle_name": "MICHELLE",
        "name_prefix": "Mrs.",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-11-17",
        "last_updated": "2015-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CT",
            "license": "003711",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "3415252",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tallahassee, FL

Sources for this page

Verify at the official NPI Registry.