Boulder Pointe Equestrian & Event Center, LLC

Primary specialty

Point of ServiceTaxonomy code 305S00000X

Legal business name

BOULDER POINTE EQUESTRIAN & EVENT CENTER, LLC

Practice address

6612 189TH LN NW
Anoka, MN 55303-9519

Phone

(952) 220-6028

NPI assigned

Feb 17, 2022

Organization subpart

No

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

Authorized official

Name

Brandon Gustafson

Title

Vice President

Phone

(952) 220-6028

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1645056000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1645056000000",
    "number": "1730834896",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6612 189TH LN NW",
            "city": "ANOKA",
            "state": "MN",
            "postal_code": "553039519",
            "telephone_number": "952-220-6028"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6612 189TH LN NW",
            "city": "ANOKA",
            "state": "MN",
            "postal_code": "553039519",
            "telephone_number": "952-220-6028"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BOULDER POINTE EQUESTRIAN & EVENT CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-02-17",
        "last_updated": "2022-02-17",
        "certification_date": "2022-02-17",
        "status": "A",
        "authorized_official_last_name": "GUSTAFSON",
        "authorized_official_first_name": "BRANDON",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "952-220-6028"
    },
    "taxonomies": [
        {
            "code": "305S00000X",
            "taxonomy_group": "",
            "desc": "Point of Service",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Hellen J Boit, APRN, DNP
• Alison Bollman, LCSW
• Shannon Bookwalter, LADC
• Dana Lynn Bork, MS-CCC-SLP
• Jayme A Bork, DO
• Jodi Le Bourgoin
• Benjamin Braus, MD
• Joni Karla Britton, MA ED, LICSW
• Frances Hart Broghammer, M.D.
• Monet Bromley

• All providers in Anoka, MN
• Point of Service in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 2022; 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.