Active NPI
Anne M Boileau, DO
- Family Medicine Physician
- Iowa City, IA
National Provider Identifier
1942235619
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 3515
- Practice address
- 269 N 1St Ave
Iowa City, IA 52245-3616 - Phone
- (319) 351-6852
- Fax
- (319) 351-2625
- NPI assigned
- Jul 11, 2006
- Last updated
- Dec 21, 2012
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 3515 | IA | Primary |
Addresses
Primary practice location
269 N 1St Ave
Iowa City, IA 52245-3616
Mailing address
1011 Arthur Street
P O Box 2027
Iowa City, IA 52244-2027
Phone (319) 339-3541
Other identifiers 5
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 39440 | Other | IA | BRITT CLINIC WELLMARK |
| 4428052 | Medicaid | IA | |
| 5428052 | Medicaid | IA | |
| 3428052 | Medicaid | IA | |
| 39441 | Other | IA | GARNER WELLMARK |
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
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3515 | IA | MD | Family Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1152576000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1356048000000",
"number": "1942235619",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1011 ARTHUR STREET",
"address_2": "P O BOX 2027",
"city": "IOWA CITY",
"state": "IA",
"postal_code": "522442027",
"telephone_number": "319-339-3541",
"fax_number": "319-358-2737"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "269 N 1ST AVE",
"city": "IOWA CITY",
"state": "IA",
"postal_code": "522453616",
"telephone_number": "319-351-6852",
"fax_number": "319-351-2625"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BOILEAU",
"first_name": "ANNE",
"middle_name": "M",
"credential": "DO",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-07-11",
"last_updated": "2012-12-21",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "IA",
"license": "3515",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BRITT CLINIC WELLMARK",
"identifier": "39440",
"state": "IA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "4428052",
"state": "IA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "5428052",
"state": "IA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "3428052",
"state": "IA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "GARNER WELLMARK",
"identifier": "39441",
"state": "IA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Iowa City, IA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 21, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.