Kennedie Ann Boehm, DNP, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

AP61329027 Issued in WA

Practice address

19005 SE 34TH St
Vancouver, WA 98683-1450

Phone

(360) 726-6720

NPI assigned

Jun 28, 2022

Last updated

Jun 28, 2022By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Enrolled in OR

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

Specialty

Nurse Practitioner

Education

Other, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Multnomah CountyGroup PAC ID 6608771787, 111 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kboehm622473@direct.ochin.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.

• Multnomah County

  dba Multnomah County Health Dept, North Portland

  • Federally Qualified Health Center (FQHC)
  • Portland, OR
  • NPI 1609914787
  Medicare reassignment Care Compare group NPD
• Multnomah County

  dba Fernhill Health Center

  • Federally Qualified Health Center (FQHC)
  • Portland, OR
  • NPI 1508904681
  NPD
• Multnomah County

  • Federally Qualified Health Center (FQHC)
  • Gresham, OR
  • NPI 1912322074
  NPD

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

{
    "created_epoch": "1656374400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1656374400000",
    "number": "1841922895",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5308 W LEGENDA CT",
            "city": "HERRIMAN",
            "state": "UT",
            "postal_code": "840965408",
            "telephone_number": "701-214-1574"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19005 SE 34TH ST",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986831450",
            "telephone_number": "360-726-6720"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOEHM",
        "first_name": "KENNEDIE",
        "middle_name": "ANN",
        "credential": "DNP, FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-06-28",
        "last_updated": "2022-06-28",
        "certification_date": "2022-06-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WA",
            "license": "AP61329027",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bodyfit Chiropractic
• Bodyworks Movement and Massage
• Debbie Boe, LMP,CR, NCMMT
• Cheryl Lee Boedigheimer, P.T.
• Bernice Boehm-Soltero
• Rick D Boehm, LMHC, MAC, MS
• Krystle Boell
• Brittany Bogales
• Bogdan N Bodroug, DDS, PS (Quality Dental Care)
• Aleksey Bogdanov, LMT

• Family Nurse Practitioner in Vancouver, WA
• Providers in Vancouver, WA by specialty
• Family Nurse Practitioner in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 2022; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.