Kathryn Elaine Boehm, MD, MS

Primary specialty

Pediatric Adolescent Medicine PhysicianTaxonomy code 2080A0000X

License

35-05-6573-B Issued in OH

Practice address

424 W Woodruff Ave
Toledo, OH 43604-5027

Phone

(419) 509-6798

Fax

(866) 888-0321

NPI assigned

May 27, 2005

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

Other identifiers 4

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine, Master of Science

Practice roles

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.

• Kathryn E. Boehm, MD, LLC

  • Clinic/Center
  • Toledo, OH
  • NPI 1104052844
  NPD (past) Authorized official
• University of Toledo Physicians LLC

  • Internal Medicine Physician
  • Toledo, OH
  • NPI 1942296033
  NPD (past)

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

{
    "created_epoch": "1117152000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1790788248",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2228 BRIDLEWOOD DR",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436141003",
            "telephone_number": "419-509-6798",
            "fax_number": "866-888-0321"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "424 W WOODRUFF AVE",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436045027",
            "telephone_number": "419-509-6798",
            "fax_number": "866-888-0321"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOEHM",
        "first_name": "KATHRYN",
        "middle_name": "ELAINE",
        "name_prefix": "Dr.",
        "credential": "MD, MS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-05-27",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080A0000X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Adolescent Medicine",
            "state": "OH",
            "license": "35-05-6573-B",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2827491-180",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAID GROUP NUMBER",
            "identifier": "3159862",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0744430",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "35-05-6573-B",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Margaret Feuille Bockrath, PH.D.
• Angela Boday
• Ernest G Bode Jr., M.D.
• Body Resort, LLC
• Tina Boeck, CRNA
• Connor R Boehme
• Catherine A. Boellner, LISW, MSW
• Ioan Sorin Boeriu, DDA,MSD
• Sarah Elizabeth Boerst, OTD, OTR/L
• Alicia Boes

• Pediatric Adolescent Medicine Physician in Toledo, OH
• Providers in Toledo, OH by specialty
• Pediatric Adolescent Medicine Physician in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; 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.