MRS. ABIGAIL BOETHIN (NPI# 1023369212) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1023369212 |
| Entity Type | Individual |
| Full Name | MRS. ABIGAIL BOETHIN |
| Credential | P.A.-C |
| Practice Address |
2521 Glenn Hendren Dr Ste 306 Liberty MO 64068-3388 |
| Mailing Address |
Po Box 219672 Kansas City MO 64121-9672 |
| Practice Telephone | 8164075490 |
| Practice Fax Number | 8164075469 |
| Mailing Telephone | 8164075490 |
| Mailing Fax Number | 8164075469 |
| Enumeration Date | 2012-09-27 |
| Last Update Date | 2014-09-25 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 363A00000X | Physician Assistant | 2012033522 | MO | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363AM0700X |
Physician Assistant Specialization: Medical |
2012033522 | MO | Physician Assistants & Advanced Practice Nursing Providers |
| Y | 363AS0400X |
Physician Assistant Specialization: Surgical Technologist |
2012033522 | MO | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
2521 GLENN HENDREN DR STE 306 |
| City | LIBERTY |
| State | MO |
| Zip Code | 64068-3388 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740283753 | Thomas F Jones | Specialist | 2521 Glenn Hendren Dr, Ste 408, Liberty, MO 64068-3388 | 2005-05-23 |
| 1548719750 | Sarah Love | Nurse Practitioner | 2521 Glenn Hendren Dr, Suite 306, Liberty, MO 64068-3388 | 2016-09-28 |
| 1750838421 | Crowntown General Surgery, PC | Surgery | 2521 Glenn Hendren Dr, Suite 410, Liberty, MO 64068-3388 | 2016-09-09 |
| 1740609460 | Katie Brewer | Audiologist | 2521 Glenn Hendren Dr, Suite 104, Liberty, MO 64068-3388 | 2014-04-09 |
| 1750633327 | New Liberty Hospital Corporation | Internal Medicine | 2521 Glenn Hendren Dr, Suite 306, Liberty, MO 64068-3388 | 2012-10-08 |
| 1215288733 | New Liberty Hospital Corporation | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 2521 Glenn Hendren Dr, Suite 308, Liberty, MO 64068-3388 | 2012-09-24 |
| 1013146448 | Liberty Cardiovascular Specialists | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 2521 Glenn Hendren Dr, Suite 306, Liberty, MO 64068-3388 | 2009-07-07 |
| 1093940157 | Kirstie Schneider Van Ry | Surgery | 2521 Glenn Hendren Dr, Ste 108, Liberty, MO 64068-3388 | 2009-05-19 |
| 1457597205 | Carlene Marie Breen | Nurse Practitioner | 2521 Glenn Hendren Dr, Ste 306, Liberty, MO 64068-3388 | 2008-12-29 |
| 1740444611 | Sheryl Ann Nespory | Registered Nurse | 2521 Glenn Hendren Dr, Suite 410, Liberty, MO 64068-3388 | 2008-07-10 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700437258 | Midwestern Medical Consultants LLC | Assisted Living Facility | 227 W. Franklin St, Liberty, MO 64068 | 2019-09-26 |
| 1063935062 | Jennifer Nichole Gibson | Nurse Practitioner | Liberty Hospital 2525 Glen Hendren Dr, Liberty, MO 64068 | 2017-07-21 |
| 1598288755 | Lhlc Operations, LLC | Skilled Nursing Facility | 2609 Glenn Hendren Dr Ste G100, Liberty, MO 64068 | 2017-07-19 |
| 1023438371 | Sarah E Ehlers | Social Worker | 1170 W. Kansas Ave, Bldg 10, Liberty, MO 64068 | 2014-04-24 |
| 1629498563 | Kelli Hedgpeth | Physical Therapy Assistant | 3980 South Jackson Dr, Independence, MO 64068 | 2014-04-18 |
| 1639593965 | Klein Dental Group LLC | Clinic/Center | 12 Westwoods Dr, Liberty, MO 64068 | 2014-02-06 |
| 1124457239 | Sarah Ehlers, Lcsw LLC | Social Worker | 1170 W Kansas Ave, Bldg 10, Liberty, MO 64068 | 2013-11-08 |
| 1134561558 | Holly Hemphill | Marriage & Family Therapist | 117 N. Water Street, Liberty, MO 64068 | 2013-07-26 |
| 1093157133 | Tina Wilma Sanborn | Marriage & Family Therapist | 1170 W. Kansas St., Liberty, MO 64068 | 2013-07-17 |
| 1609215441 | Timothy Adam Lynch | Marriage & Family Therapist | 1170 West Kansas Ave., Liberty, MO 64068 | 2013-06-14 |
| Find all providers in zip 64068 | ||||
| Taxonomy Code | 363AS0400X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Surgical Technologist |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891806568 | Leigh Ann Johnson | Physician Assistant | 2521 Glenn Hendren Dr, Suite 308, Liberty, MO 64068-3388 | 2006-08-31 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184259079 | Dustin Edward Hemker | Physician Assistant | 937 Blake Ct, Saint Peters, MO 63376-5527 | 2020-03-11 |
| 1730669169 | Hannah Eagleburger | Physician Assistant | 4321 Wornall Rd, Ste 530, Kansas City, MO 64111 | 2018-08-15 |
| 1770073587 | Ashton Marie Roberts | Physician Assistant | 1 Hospital Dr # Dc077.00, Columbia, MO 65212-1000 | 2018-05-16 |
| 1295257285 | Katelynn Elizabeth Austin | Physician Assistant | 3250 Gordonville Rd Ste 384, Cape Girardeau, MO 63703-5095 | 2017-07-11 |
| 1407214364 | Kathryn Rebecca Bachman | Physician Assistant | 226 S Woods Mill Rd Ste 35w, Chesterfield, MO 63017-3442 | 2016-02-08 |
| 1699148429 | Michael Farrell | Physician Assistant | 7827 Highway N Ste 104, O Fallon, MO 63368-6704 | 2015-11-02 |
| 1427441492 | Cornerstone First Assisting | Physician Assistant | 267 Countryshire Dr, Lake St Louis, MO 63367-5823 | 2015-03-14 |
| 1205232915 | Pa Staffing LLC | Physician Assistant | 408 Ballwin Ave, Ballwin, MO 63021-5213 | 2014-11-06 |
| 1568702090 | Jamie Lyn Mertz | Physician Assistant | 9423 N Wayne Ct, Kansas City, MO 64155-2999 | 2013-02-20 |
| 1245586536 | Jeb Medical LLC | Physician Assistant | 1215 Clay St, Kansas City, MO 64116-4026 | 2012-07-24 |
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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.