Active NPI
Michael Boller
- Pharmacist
- Cedar Falls, IA
National Provider Identifier
1861002776
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 23859
- Practice address
- 5100 Prairie Pkwy Ste 106
Cedar Falls, IA 50613-8155 - Phone
- (319) 222-2906
- NPI assigned
- Aug 5, 2020
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 23859 | IA | Primary |
Addresses
Primary practice location
5100 Prairie Pkwy Ste 106
Cedar Falls, IA 50613-8155
Mailing address
2115 Grand Blvd
Cedar Falls, IA 50613-4760
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 23859 | IA | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Allen Memorial Hospital Corporation | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Clinic Pharmacy
- Cedar Falls, IA
- NPI 1598215659
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1596585600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1596585600000",
"number": "1861002776",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2115 GRAND BLVD",
"city": "CEDAR FALLS",
"state": "IA",
"postal_code": "506134760"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5100 PRAIRIE PKWY STE 106",
"city": "CEDAR FALLS",
"state": "IA",
"postal_code": "506138155",
"telephone_number": "319-222-2906"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BOLLER",
"first_name": "MICHAEL",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2020-08-05",
"last_updated": "2020-08-05",
"certification_date": "2020-08-05",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "IA",
"license": "23859",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Cedar Falls, IA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.