Active NPI
Stephanie Boike, ARNP
- Nurse Practitioner
- Traverse City, MI
National Provider Identifier
1922479591
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- 4704274742
- Practice address
- 4020 Copper VW Ste 104
Traverse City, MI 49684-7041 - Phone
- (231) 421-6921
- NPI assigned
- Oct 8, 2015
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | ARNP9379468 | FL | |
| Nurse Practitioner | 363L00000X | 4704274742 | MI | Primary |
Addresses
Primary practice location
4020 Copper VW Ste 104
Traverse City, MI 49684-7041
Mailing address
1014 6TH St
Ste 101
Traverse City, MI 49684-2381
Phone (231) 421-6921
Other practice location 1
1014 Sixth St
Ste 101
Traverse City, MI 49684-2381
Phone (231) 421-6921
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 015841800 | Medicaid | FL | |
| Y0T5F | Other | FL | BCBS |
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)
- Enrolled
- Credentials
- Nurse Practitioner
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1444262400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1535068800000",
"number": "1922479591",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1014 6TH ST",
"address_2": "STE 101",
"city": "TRAVERSE CITY",
"state": "MI",
"postal_code": "496842381",
"telephone_number": "231-421-6921",
"fax_number": "231-421-7852"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4020 COPPER VW STE 104",
"city": "TRAVERSE CITY",
"state": "MI",
"postal_code": "496847041",
"telephone_number": "231-421-6921"
}
],
"practiceLocations": [
{
"address_1": "1014 Sixth St",
"address_2": "Ste 101",
"address_purpose": "LOCATION",
"city": "Traverse City",
"state": "MI",
"postal_code": "496842381",
"country_code": "US",
"telephone_number": "231-421-6921",
"fax_number": "231-421-7852",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "BOIKE",
"first_name": "STEPHANIE",
"credential": "ARNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-10-08",
"last_updated": "2018-08-24",
"status": "A"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "FL",
"license": "ARNP9379468",
"primary": false
},
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "MI",
"license": "4704274742",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "015841800",
"state": "FL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "Y0T5F",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Traverse City, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.