Individual provider Active NPI

Yaw Otchere-Boateng, MD

  • Internal Medicine Physician
  • Charleston, WV
National Provider Identifier
1881668937
Registry record updated Feb 25, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
29872 Issued in WV
Practice address
1627 Quarrier St
Charleston, WV 25311-2124
Phone
(757) 536-2246
NPI assigned
Feb 15, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 25, 2021

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

Specialties & licenses 8

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X
Emergency Medicine Physician 207P00000X 40708 TN
Internal Medicine Physician 207R00000X 0101242839 VA
Internal Medicine Physician 207R00000X 40708 TN
Addiction Medicine (Internal Medicine) Physician 207RA0401X FO3926663 TN
Hospitalist Physician 208M00000X 40708 TN
Hospitalist Physician 208M00000X 43217 KY
Internal Medicine Physician 207R00000X 29872 WV Primary

Addresses

Primary practice location

1627 Quarrier St
Charleston, WV 25311-2124

Mailing address

1005 Carrington CT
Kingsport, TN 37660-5694
Phone (236) 777-0404

Other practice location 1

2901 S Lynnhaven Rd Ste 450
Virginia Beach, VA 23452-8524
Phone (757) 536-2246

Other names 1

  • Yaw Otchere-Boateng Professional name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN, NC, GA3 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
I20060317000404 TN Practitioner - Internal Medicine 7911920236 Reassigns benefits to 3 organizations
I20091110000194 NC Practitioner - Internal Medicine 7911920236 Reassigns benefits to 1 organization
I20220916001530 GA Practitioner - Internal Medicine 7911920236 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
29872WVMDInternal Medicine Physician
FO3926663TNMDAddiction Medicine (Internal Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
App of Tennessee HM, PLLC Emergency Medicine CurrentSince Dec 1, 2019 Accepting new patients
Cogent Healthcare of Tennessee, PC Internal Medicine CurrentSince Nov 1, 2015 Accepting new patients
Cogent Healthcare of Macon, LLC Internal Medicine CurrentSince Aug 1, 2022 Accepting new patients
Williamston Clinic Corp Internal Medicine CurrentSince Aug 28, 2019 Accepting new patients
Saint Thomas Medical Partners Internal Medicine CurrentSince Feb 1, 2015 Accepting new patients
Inpatient Medical Services, PC Hospitalist Past Accepting new patients
Primedoc Park Ridge PA Internal Medicine Past Accepting new patients
Comprehensive Hospitalist Services of South Carolina Hospitalist Past Accepting new patients
Inpatient Consultants of Tennessee, P.C. Internal Medicine Past Accepting new patients
Southeastern Physician Services PC Internal Medicine Past Accepting new patients

Locations

777 Hemlock St
#104
Macon, GA 31201
Phone (478) 633-7550

777 Hemlock St
Macon, GA 31201
Phone (478) 474-5600

104 Medical Dr
Williamston, NC 27892
Phone (252) 809-6300

310 S McCaskey Rd
Williamston, NC 27892
Phone (252) 809-6133

2305 Chambliss Ave NW
Cleveland, TN 37311
Phone (423) 559-6000

1 Medical Center Blvd
Cookeville, TN 38501
Phone (931) 783-2334

400 E Tickle St
Dyersburg, TN 38024
Phone (731) 285-2410

4321 Carothers Pkwy
Franklin, TN 37067
Phone (615) 435-5000

110 Hospital Dr
Jefferson Cty, TN 37760
Phone (865) 471-2431

1411 W Baddour Pkwy
Lebanon, TN 37087
Phone (615) 443-2500

410 W Crawford Ave
Monterey, TN 38574
Phone (931) 537-6524

300 20th Ave N
Fl 9
Nashville, TN 37203

435 2nd St
Newport, TN 37821
Phone (423) 625-2200

2835 Highway 231 N
Shelbyville, TN 37160
Phone (931) 685-5433

Interoperability endpoints

  • Direct secure messaging: yotche02@yourcarecommunity.org

Organizations & group practices 10

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.

NPI Registry JSON

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

{
    "created_epoch": "1139961600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614211200000",
    "number": "1881668937",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1005 CARRINGTON CT",
            "city": "KINGSPORT",
            "state": "TN",
            "postal_code": "376605694",
            "telephone_number": "236-777-0404"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1627 QUARRIER ST",
            "city": "CHARLESTON",
            "state": "WV",
            "postal_code": "253112124",
            "telephone_number": "757-536-2246"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2901 S Lynnhaven Rd Ste 450",
            "address_purpose": "LOCATION",
            "city": "Virginia Beach",
            "state": "VA",
            "postal_code": "234528524",
            "country_code": "US",
            "telephone_number": "757-536-2246",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "OTCHERE-BOATENG",
        "first_name": "YAW",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-15",
        "last_updated": "2021-02-25",
        "certification_date": "2021-02-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "TN",
            "license": "40708",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "VA",
            "license": "0101242839",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TN",
            "license": "40708",
            "primary": false
        },
        {
            "code": "207RA0401X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Addiction Medicine",
            "state": "TN",
            "license": "FO3926663",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "TN",
            "license": "40708",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "KY",
            "license": "43217",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "WV",
            "license": "29872",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "YAW",
            "last_name": "OTCHERE-BOATENG",
            "credential": "MD",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Charleston, WV

Sources for this page

Verify at the official NPI Registry.