DR. DOUGLAS L BOERTJE (NPI# 1558361246) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1558361246 |
Entity Type | Individual |
Full Name | DR. DOUGLAS L BOERTJE |
Credential | MD |
Practice Address |
501 S Sharon Amity Rd Ste 300 Charlotte NC 28211-0035 |
Practice Telephone | 7043772424 |
Practice Fax Number | 7043772687 |
Mailing Telephone | 7043772424 |
Mailing Fax Number | 7043772687 |
Enumeration Date | 2005-07-26 |
Last Update Date | 2018-11-28 |
Gender Code | M |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 207PP0204X |
Emergency Medicine Specialization: Pediatric Emergency Medicine |
2006-01516 | NC | Allopathic & Osteopathic Physicians |
N | 207PP0204X |
Emergency Medicine Specialization: Pediatric Emergency Medicine |
36257 | TN | Allopathic & Osteopathic Physicians |
State | Issuer | Identifier | Type Code |
---|---|---|---|
NC | 59-05661 | 05 | |
SC | SC MEDICAID | N01517 | 01 |
Street Address |
501 S SHARON AMITY RD STE 300 |
City | CHARLOTTE |
State | NC |
Zip Code | 28211-0035 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1568092989 | Jillian Marie Rengel | Nurse Practitioner | 501 S Sharon Amity Rd Ste 300, Charlotte, NC 28211-0035 | 2020-01-24 |
1043840721 | Johanna Isabelle Rossitch | Physician Assistant | 501 S Sharon Amity Rd Ste 300, Charlotte, NC 28211-0035 | 2020-01-22 |
1952875478 | Whitney Kristine Lloyd | Nurse Practitioner | 501 S Sharon Amity Rd Ste 300, Charlotte, NC 28211-0035 | 2019-01-17 |
1902370653 | Stephen Logan Groves | Physician Assistant | 501 S Sharon Amity Rd Ste 300, Charlotte, NC 28211-0035 | 2019-01-16 |
1639604390 | Kyle Francis Grimaldi | Emergency Medicine | 501 S Sharon Amity Rd Ste 300, Charlotte, NC 28211-0035 | 2017-05-01 |
1558892604 | Christopher Allen Gardner | Emergency Medicine | 501 S Sharon Amity Rd Ste 300, Charlotte, NC 28211-0035 | 2017-03-21 |
1194264382 | Ross Mckelvey Williams | Physician Assistant | 501 S Sharon Amity Rd Ste 300, Charlotte, NC 28211-0035 | 2017-02-21 |
1194189886 | Johanna Elizabeth Kreafle | Emergency Medicine | 501 S Sharon Amity Rd Ste 300, Charlotte, NC 28211 | 2016-04-08 |
1164884961 | Aaron Michael Blackshaw | Emergency Medicine | 501 S Sharon Amity Rd Ste 300, Charlotte, NC 28211-0035 | 2016-03-22 |
1811378516 | Caileigh A Skogg | Physician Assistant | 501 S Sharon Amity Rd Ste 300, Charlotte, NC 28211-0035 | 2015-06-18 |
Find all providers in the same location |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1184277832 | I and J Wheelchair Transportation | Non-emergency Medical Transport (VAN) | 1512 Delane Avenue, Charlotte, NC 28211 | 2019-07-22 |
1922563923 | The Charlotte-mecklenburg Hospital Authority | Psychiatry & Neurology | 447 Billingsley Rd, Cottage A, Charlotte, NC 28211 | 2019-02-04 |
1649798273 | Ally Home Care Charlotte LLC | In Home Supportive Care | 3711 Latrobe Drive Suite 520, Charlotte, NC 28211 | 2017-09-04 |
1154866770 | Vaibhav Bajaj | Dentist | 2809 Coltsgate Rd Ste 200, Charlotte, NC 28211 | 2017-01-05 |
1508254939 | Lindsay Marie Smits | Speech-Language Pathologist | 427 N. Wendover Rd., Charlotte, NC 28211 | 2015-01-08 |
1457755480 | Kristen Hammer | Physical Therapy Assistant | 4120 Providence Rd Apt D, Charlotte, NC 28211 | 2014-10-20 |
1669805610 | Carla Elizabeth Scott | Physical Therapist | 3500 Ellington Street, Dr. Carlton Watkins Center, Charlotte, NC 28211 | 2013-08-14 |
1760726368 | Jill Hensdale Shipp | Social Worker | 307 Hunter Lane, Charlotte, NC 28211 | 2012-11-20 |
1346592722 | Danielle Marie Benoit | Occupational Therapist | 3541 Randolph Road Suite 100 W, Charlotte, NC 28211 | 2012-10-09 |
1487910832 | John Joseph Marcel Jr. | Orthopaedic Surgery | 449 North Wendover Rd Ste A, Charlotte, NC 28211 | 2012-04-10 |
Find all providers in zip 28211 |
Taxonomy Code | 207PP0204X |
Grouping | Allopathic & Osteopathic Physicians |
Classification | Emergency Medicine |
Specialization | Pediatric Emergency Medicine |
Pediatric Emergency Medicine is a clinical subspecialty that focuses on the care of the acutely ill or injured child in the setting of an emergency department. |
Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source] Additional Resources: American Board of Emergency Medicine, 2007. http://www.abem.org/public/ Board certification is provided by the American Board of Emergency Medicine. Board certification for Medical Doctors (MDs) is provided by the American Board of Emergency Medicine. |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1619932746 | Joanna E York | Emergency Medicine | 1900 Randolph Road, Suite 900, Charlotte, NC 28207-1117 | 2006-04-20 |
1477729556 | Lindsey Chaudoin | Emergency Medicine | 1000 Blythe Blvd, Charlotte, NC 28203-5812 | 2008-05-07 |
1093987794 | James Robert Young | Emergency Medicine | 501 S Sharon Amity Rd Ste 300, Charlotte, NC 28211 | 2008-04-02 |
1497804603 | Thomas Davis Miller IIi | Emergency Medicine | 501 S Sharon Amity Rd Ste 300, Charlotte, NC 28211-0035 | 2007-01-09 |
1043367915 | Cody Garrett Carpenter | Emergency Medicine | 501 S Sharon Amity Rd Ste 300, Charlotte, NC 28211-0035 | 2007-01-04 |
1083651319 | John W Ringwood | Emergency Medicine | 1900 Randolph Rd, Ste 900, Charlotte, NC 28207-1106 | 2006-06-02 |
1992759591 | Sara H Steelman | Emergency Medicine | 501 S Sharon Amity Rd Ste 300, Charlotte, NC 28211-0035 | 2006-05-19 |
1508815457 | Michelle C Capizzi | Emergency Medicine | 501 S Sharon Amity Rd Ste 300, Charlotte, NC 28211-0035 | 2006-05-09 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1639559883 | Lindly Theroux | Emergency Medicine | 1 Medical Center Blvd, Winston Salem, NC 27157-2038 | 2015-06-03 |
1770756157 | Timothy M Galey | Emergency Medicine | Medical Center Blvd, Winston Salem, NC 27157-0001 | 2008-04-08 |
1962686089 | Ross Jacob Kuhner | Emergency Medicine | 1200 N Elm St, Greensboro, NC 27401-1004 | 2007-12-26 |
1689881625 | Chad David Mccalla | Emergency Medicine | Medical Center Blvd, Winston Salem, NC 27157-0001 | 2007-05-17 |
1922154533 | Michael S Mitchell | Emergency Medicine | Medical Center Blvd, Winston Salem, NC 27157-0001 | 2007-01-26 |
1861564965 | Shad M Baab | Emergency Medicine | 1200 N Elm St, Greensboro, NC 27401-1004 | 2006-11-14 |
1164508297 | Edwin B Robins | Emergency Medicine | 1638 Owen Drive, Fayetteville, NC 28304-3234 | 2006-10-31 |
1902881717 | Douglas Keith Holtzman | Emergency Medicine | 101 Manning Dr, Chapel Hill, NC 27514-4220 | 2005-12-14 |
1326048760 | Donald T Ellis II | Emergency Medicine | 2100 Erwin Rd, Durham, NC 27710-0001 | 2005-07-28 |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.