KELLIE L BOEGGEMAN (NPI# 1669662086) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1669662086 |
| Entity Type | Individual |
| Full Name | KELLIE L BOEGGEMAN |
| Credential | ARNP |
| Practice Address |
704 Gold Hill Road Fort Mill SC 29715-8905 |
| Mailing Address |
P.o Box 602110 Charlotte NC 28260-2110 |
| Practice Telephone | 7046673380 |
| Practice Fax Number | 7046673381 |
| Mailing Telephone | 7046673380 |
| Mailing Fax Number | 7046673381 |
| Enumeration Date | 2007-08-01 |
| Last Update Date | 2013-03-08 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 363L00000X | Nurse Practitioner | 248427 | NC | Physician Assistants & Advanced Practice Nursing Providers |
| Y | 363L00000X | Nurse Practitioner | APN355 | SC | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363LF0000X |
Nurse Practitioner Specialization: Family |
9165739 | FL | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| SC | NP1310 | 05 | |
| NC | 7006413 | 05 |
| Street Address |
704 GOLD HILL ROAD |
| City | FORT MILL |
| State | SC |
| Zip Code | 29715-8905 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497788079 | Piedmont Gynecological and Obstetrical Associates | Obstetrics & Gynecology | 704 Gold Hill Road, Ste 215, Fort Mill, SC 29715-8907 | 2006-07-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710590278 | South Carolina Cvs Pharmacy LLC | Durable Medical Equipment & Medical Supplies | 1919 Springfield Parkway, Fort Mill, SD 29715 | 2020-08-25 |
| 1336759307 | Elizabeth Blakeney Sitton | Dentist | 3463 Us-21 #101, Fort Mill, SC 29715 | 2020-08-05 |
| 1730715293 | Fort Mill Dobys Bridge Dental LLC | Clinic/Center | 1500 Fort Mill Pkwy #108, Fort Mill, SC 29715 | 2020-03-17 |
| 1841728755 | Dennis Demetrius Williams | Specialist/Technologist | 1179 Madison Green Dr, Fort Mill, SC 29715 | 2017-05-23 |
| 1437684453 | Specialty Orthopaedics and Sports Medicine | Orthopaedic Surgery | 130 Crisanto Ave Ste B, Fort Mill, SC 29715 | 2017-04-27 |
| 1730624115 | Springfield Dentistry | Dentist | 452 Mercantile Place, Fort Mill, SC 29715 | 2016-12-21 |
| 1700335569 | Melby Transitions Mht LLC | Internal Medicine | 1148 Wessington Manor Ln, Fort Mill, SC 29715 | 2016-09-22 |
| 1629434071 | Palmetto Family Pharmacy Regent Park | Pharmacy | 1046 Regent Parkway, Suite 104, Fort Mill, SC 29715 | 2016-01-14 |
| 1619374220 | Rebecca Rowe | Speech-Language Pathologist | 8835 Gladden Hill Ln, Fort Mill, SC 29715 | 2014-11-25 |
| 1003248873 | Terri Hennessey | Speech-Language Pathologist | 1599 Farm House Dr, Fort Mill, SC 29715 | 2013-08-05 |
| Find all providers in zip 29715 | ||||
| Taxonomy Code | 363L00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| (1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners. |
| Notes: Source: (1) American Nurses’ Association, American Nurses Credentialing Center, 1996 Certification Catalogue. (2) ) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, The Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, Illinois: 1994, p. 549. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346881398 | Svetlana Danilova | Nurse Practitioner | 173 Mills Ln, Fort Mill, SC 29708-5706 | 2019-10-01 |
| 1265089098 | Jennifer Priory O'keefe | Nurse Practitioner | 117 Stone Village Dr., Fort Mill, SC 29708 | 2019-08-26 |
| 1437684271 | Krystal Lane | Nurse Practitioner | 710 Joy Dr, Fort Mill, SC 29715-8402 | 2017-05-01 |
| 1235520818 | Fabiana Rievers Troxler | Nurse Practitioner | 127 Ben Casey Dr Ste 106, Fort Mill, SC 29708-6600 | 2015-02-18 |
| 1194837633 | Marilee M. Calamas | Nurse Practitioner | 1690 Highway 160 West, Fort Mill, SC 29708-8024 | 2006-08-31 |
| 1780292516 | Joshua Ballard | Nurse Practitioner | 6237 Carolina Commons Dr Ste 101, Fort Mill, SC 29707-4511 | 2020-07-17 |
| 1114409836 | Meghan Bynum | Nurse Practitioner | 704 Gold Hill Rd, Ste 1200, Fort Mill, SC 29715-8906 | 2018-08-29 |
| 1568942696 | Jeremy L Adams | Nurse Practitioner | 1808 Second Baxter Xing, Fort Mill, SC 29708-6436 | 2018-08-17 |
| 1639664477 | Julie Emery | Nurse Practitioner | 515 Rivercrossing Dr Ste 180, Fort Mill, SC 29715-7900 | 2018-06-25 |
| 1194222505 | Lisa Nicole Morrison | Nurse Practitioner | 1245 Rosemont Dr Ste 120, Fort Mill, SC 29707-7765 | 2018-04-11 |
| Find all providers in FORT MILL | ||||
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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.