DAMON M BOOGAART DNP CFNP NPI 1538160403

NPI Information

NPI: 1538160403
Provider Name: DAMON M BOOGAART, DNP, CFNP
Classification: Nurse Practitioner - 363LF0000X
Entity Type: Individual

Specialization: Family

PECOS Registration: Yes

Address:
2570 SOM CENTER RD
WILLOUGHBY, OH
ZIP 44094
Phone: (440) 943-2500
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Damon M Boogaart, DNP, CFNP is a family nurse practitioner in Willoughby, OH with 28 years of experience. Damon M Boogaart, DNP, CFNP NPI is 1538160403. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

2570 SOM CENTER RD
WILLOUGHBY, OH
ZIP 44094-607
Phone: (440) 943-2500
Fax: (440) 516-8345

The NPI 1538160403 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 8/2/2005 and was last updated on 4/17/2015.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363LF0000X	Nurse Practitioner	Family	71000544A	INDIANA	No
2	363LF0000X	Nurse Practitioner	Family	NP 08627	OHIO	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	100321450	MEDICAID	INDIANA
2	2288117	MEDICAID	OHIO
3	BONP80191	MEDICARE PIN	OHIO
4	000000297161	OTHER	INDIANA	BC/BS #
5	S84662	MEDICARE UPIN	INDIANA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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