Individual provider Active NPI

Polly Erin Boyer, NP

  • Primary Care Nurse Practitioner
  • Fort Campbell, KY
National Provider Identifier
1902241540
Registry record updated Aug 18, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Nurse PractitionerTaxonomy code 363LP2300X
License
339055 Issued in OH
Practice address
650 Joel Drive
Fort Campbell, KY 42223
Phone
(270) 798-8388
NPI assigned
May 9, 2013
Last updated
Aug 18, 2015By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 18, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X COA.144476-NP OH
Primary Care Nurse Practitioner 363LP2300X 339055 OH Primary

Addresses

Primary practice location

650 Joel Drive
Fort Campbell, KY 42223

Mailing address

650 Joel Drive
Fort Campbell, KY 42223
Phone (270) 798-8388

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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

Enrollment IDStateProvider typePAC IDDetails
I20230918002737 OH Practitioner - Nurse Practitioner 4587028907 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Wood Health Company LLCGroup PAC ID 7911800461, 61 clinicians

Practice addresses (Care Compare)

838 E Wooster St
Bowling Green, OH 43402-2601
Phone (419) 372-2271

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
COA.144476-NPOHMDFamily Nurse Practitioner
339055OHMDPrimary Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Wood Health Company LLC CurrentSince Jul 22, 2023 Accepting new patients

Locations

745 Haskins Rd
Ste B
Bowling Green, OH 43402
Phone (419) 373-7607

838 E Wooster St
Bowling Green, OH 43402
Phone (419) 372-2271

141 N Keyser Ave
Deshler, OH 43516
Phone (419) 278-2065

Interoperability endpoints

  • Direct secure messaging: boyer.polly.p1@direct.whc.nextgenshare.com
  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
  • Direct secure messaging: janel.weaver.p1@direct.whc.nextgenshare.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1368057600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1439856000000",
    "number": "1902241540",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "650 JOEL DRIVE",
            "city": "FORT CAMPBELL",
            "state": "KY",
            "postal_code": "42223",
            "telephone_number": "270-798-8388"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "650 JOEL DRIVE",
            "city": "FORT CAMPBELL",
            "state": "KY",
            "postal_code": "42223",
            "telephone_number": "270-798-8388"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOYER",
        "first_name": "POLLY",
        "middle_name": "ERIN",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-05-09",
        "last_updated": "2015-08-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OH",
            "license": "COA.144476-NP",
            "primary": false
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "OH",
            "license": "339055",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Campbell, KY

Sources for this page

Verify at the official NPI Registry.