Individual provider Active NPI

Jessica Boatman

  • Case Manager/Care Coordinator
  • Lawrenceville, IL
National Provider Identifier
1982276200
Registry record updated Feb 6, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Case Manager/Care CoordinatorTaxonomy code 171M00000X
Practice address
11362 Country Club Rd
Lawrenceville, IL 62439-4325
Phone
(618) 943-3302
Fax
(618) 943-3657
NPI assigned
Jul 15, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 6, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Case Manager/Care Coordinator 171M00000X Primary

Addresses

Primary practice location

11362 Country Club Rd
Lawrenceville, IL 62439-4325

Mailing address

11362 Country Club Rd
Lawrenceville, IL 62439-4325
Phone (618) 943-3302

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jboatman@lchealth.com

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)
Not enrolled

NPI Registry JSON

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

{
    "created_epoch": "1626307200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707177600000",
    "number": "1982276200",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11362 COUNTRY CLUB RD",
            "city": "LAWRENCEVILLE",
            "state": "IL",
            "postal_code": "624394325",
            "telephone_number": "618-943-3302",
            "fax_number": "618-943-3657"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11362 COUNTRY CLUB RD",
            "city": "LAWRENCEVILLE",
            "state": "IL",
            "postal_code": "624394325",
            "telephone_number": "618-943-3302",
            "fax_number": "618-943-3657"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOATMAN",
        "first_name": "JESSICA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-07-15",
        "last_updated": "2024-02-06",
        "certification_date": "2024-02-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jboatman@lchealth.com",
            "affiliation": "N",
            "address_1": "11362 Country Club Rd",
            "city": "Lawrenceville",
            "state": "IL",
            "country_code": "US",
            "postal_code": "624394325",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Lawrenceville, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 6, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.