Cassandra Boggon

Primary specialty

SpecialistTaxonomy code 174400000X

License

2701115101 Issued in MI

Practice address

16203 Wyoming St
Detroit, MI 48221-3417

Phone

(313) 864-2788

Fax

(866) 267-7903

NPI assigned

Jun 3, 2010

Last updated

Jun 3, 2010By 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 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1275523200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1275523200000",
    "number": "1770803496",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8457 BRACE ST",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482283144",
            "telephone_number": "734-334-0208",
            "fax_number": "866-267-7903"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16203 WYOMING ST",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482213417",
            "telephone_number": "313-864-2788",
            "fax_number": "866-267-7903"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOGGON",
        "first_name": "CASSANDRA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-06-03",
        "last_updated": "2010-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "MI",
            "license": "2701115101",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Stormmy Reigh Boettcher, PHARMD
• Andrew Boeve
• Elias Sileshi Bogale, MD
• Brittany Bogan, MD
• Nancy Bogdan, LPC
• Kamera Sakeena Boggon, AGNP -C
• Jamie Boggs, MD
• Relaina Denise Bogins, LBSW, MSW,CAADC
• Rhiannon Marie-Heckel Boguszewicz, NP
• Emily Boguth, MA, CCC-SLP

• Specialist in Detroit, MI
• Providers in Detroit, MI by specialty
• Specialist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 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.