Active NPI
Boston Primary Care LLC
- Primary Care Nurse Practitioner
- Greenwell Springs, LA
National Provider Identifier
1891454328
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Primary Care Nurse Practitioner
- Legal business name
- BOSTON PRIMARY CARE LLC
- Practice address
- 18448 Magnolia Bridge Rd
Suite a
Greenwell Springs, LA 70739-4626 - Phone
- (225) 256-0063
- Fax
- (225) 256-0217
- NPI assigned
- Dec 13, 2021
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- William Boston, FNP-C
- Title
- Owner
- Phone
- (225) 328-3181
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Primary Care Nurse Practitioner | 363LP2300X | Primary |
Addresses
Primary practice location
18448 Magnolia Bridge Rd
Suite a
Greenwell Springs, LA 70739-4626
Mailing address
18448 Magnolia Bridge Rd
Suite a
Greenwell Springs, LA 70739-4626
Phone (225) 256-0063
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in LA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20220216001636 | LA | Part B Supplier - Clinic/Group Practice | 6901299809 |
Receives reassigned benefits from 6 practitioners Practice locations: Greenwell Springs, LA |
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 19D2253603 | Boston Primary Care, LLC | Certificate of waiver | Feb 22, 2028 |
National Provider Directory
National Provider DirectoryLocations
18448 Magnolia Bridge Rd
#A
Greenwell Springs, LA 70739
Phone (225) 256-0063
Interoperability endpoints
- https://api.platform.athenahealth.com/24590/brand/1/csg/1/fhir/r4
Practitioners & affiliated clinicians
Practitioners 6
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1639353600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1641513600000",
"number": "1891454328",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "18448 MAGNOLIA BRIDGE RD",
"address_2": "SUITE A",
"city": "GREENWELL SPRINGS",
"state": "LA",
"postal_code": "707394626",
"telephone_number": "225-256-0063",
"fax_number": "225-256-0217"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "18448 MAGNOLIA BRIDGE RD",
"address_2": "SUITE A",
"city": "GREENWELL SPRINGS",
"state": "LA",
"postal_code": "707394626",
"telephone_number": "225-256-0063",
"fax_number": "225-256-0217"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "BOSTON PRIMARY CARE LLC",
"organizational_subpart": "NO",
"enumeration_date": "2021-12-13",
"last_updated": "2022-01-07",
"certification_date": "2022-01-04",
"status": "A",
"authorized_official_last_name": "BOSTON",
"authorized_official_first_name": "WILLIAM",
"authorized_official_title_or_position": "OWNER",
"authorized_official_telephone_number": "225-328-3181",
"authorized_official_credential": "FNP-C"
},
"taxonomies": [
{
"code": "363LP2300X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Nurse Practitioner, Primary Care",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Greenwell Springs, LA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- 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.