MR. DAVID ALDEN BOEDEKER (NPI# 1508311085) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1508311085 |
| Entity Type | Individual |
| Full Name | MR. DAVID ALDEN BOEDEKER |
| Credential | PA-C |
| Practice Address |
508 Stocktrail Ave Suite A Gillette WY 82716-3582 |
| Mailing Address |
501 S Burma Ave Gillette WY 82716-3426 |
| Practice Telephone | 3076861413 |
| Mailing Telephone | 3076881000 |
| Enumeration Date | 2016-08-24 |
| Last Update Date | 2016-08-29 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AM0700X |
Physician Assistant Specialization: Medical |
PT696 | WY | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
508 STOCKTRAIL AVE SUITE A |
| City | GILLETTE |
| State | WY |
| Zip Code | 82716-3582 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356335533 | Powder River Orthopedics & Spine PC | Orthopaedic Surgery | 508 Stocktrail Ave, Ste A, Gillette, WY 82716-3582 | 2005-09-02 |
| 1508380049 | Brittney C Barelman | Occupational Therapist | 508 Stocktrail Ave, Gillette, WY 82716-3582 | 2017-07-26 |
| 1205165727 | Bone & Joint Radiology, LLC | Clinic/Center | 508 Stocktrail Ave, Suite A, Gillette, WY 82716-3582 | 2009-12-11 |
| 1093961179 | Stanford T Israelsen | Orthopaedic Surgery | 508 Stocktrail Ave, Suite A, Gillette, WY 82716-3582 | 2008-08-08 |
| 1316932783 | Gerald L Baker | Orthopaedic Surgery | 508 Stocktrail Ave, Ste A, Gillette, WY 82716-3582 | 2005-09-13 |
| 1427042936 | Nathan S Simpson | Orthopaedic Surgery | 508 Stocktrail Ave, Ste A, Gillette, WY 82716-3554 | 2005-09-12 |
| 1740274265 | Hans C Kioschos | Orthopaedic Surgery | 508 Stocktrail Ave, Suite A, Gillette, WY 82716-3582 | 2005-09-12 |
| 1639163702 | John P Dunn | Orthopaedic Surgery | 508 Stocktrail Ave, Suite A, Gillette, WY 82716-3582 | 2005-09-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053822387 | Diana Lynn Ohman | Dietitian, Registered | 709 West Eighth Street, Suite 4, Gillette, WY 82716 | 2017-10-13 |
| 1821457821 | Courage To Change Counseling LLC | Community/Behavioral Health | 113 S. Gillette Ave, Gillette, WY 82716 | 2016-02-18 |
| 1003290594 | Kris Huber | Community/Behavioral Health | 905 Gurley Ave, Gillette, WY 82716 | 2015-07-14 |
| 1649516857 | Shirley L Haley | Nurse Practitioner | 1304 West 4th Street, Gillette, WY 82716 | 2012-12-14 |
| 1174867188 | Rebecca J Mader | Registered Nurse | 501 South Burma Ave., Gillette, WY 82716 | 2012-11-15 |
| 1568728228 | Kerry Elizabeth Warner | Registered Nurse | 201 S Burma Ave, Gillette, WY 82716 | 2012-04-07 |
| 1720363351 | Julie Ann Faldalen | Licensed Practical Nurse | 501 South Burma, Gillette, WY 82716 | 2011-10-14 |
| 1083937486 | Clear Creek Counseling LLC | Counselor | 801 E. 4th St., Suite 24, Gillette, WY 82716 | 2010-03-12 |
| 1821241423 | Dianna L Knox | Counselor | 500 S Burma Ave, Gillette, WY 82716 | 2008-10-28 |
| 1588826887 | Scott R Hunter | Chiropractor | 439 Prairie View Place Ste D, Dr S R Hunter, Gillette, WY 82716 | 2008-06-27 |
| Find all providers in zip 82716 | ||||
| Taxonomy Code | 363AM0700X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Medical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528482254 | Julie Marie Jones | Physician Assistant | 501 S Burma Ave, Gillette, WY 82716-3426 | 2014-02-17 |
| 1497992408 | Chelsi Jean Krehmeyer | Physician Assistant | 407 S Medical Arts Ct Ste D, Gillette, WY 82716-3372 | 2009-01-13 |
| 1356592976 | Mindy Keil | Physician Assistant | 1308 W 4th St, Gillette, WY 82716-3330 | 2008-10-01 |
| 1386607158 | Mary Nell Patterson | Physician Assistant | 501 S Burma Ave, Gillette, WY 82716-3426 | 2006-04-11 |
| 1578553384 | William D Thompson | Physician Assistant | 407 S Medical Arts Ct, Suite D, Gillette, WY 82716-3372 | 2005-10-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891320172 | Sarah Coulter | Physician Assistant | 1401 W 5th Street, Attention Medical Services Staff, Sheridan, WY 82801 | 2020-03-07 |
| 1609425859 | Cori Anderson | Physician Assistant | 47 Doc Perkes Ln, Afton, WY 83110 | 2019-09-10 |
| 1730646035 | Colby Vossler | Physician Assistant | 2635 Torrington Rd, Cheyenne, WY 82009-9258 | 2019-02-23 |
| 1679910343 | Richard David Bennett | Physician Assistant | 720 Lindsay Lane, Suite C, Big Horn Basin Bone and Joint, LLC, Cody, WY 82414-4103 | 2013-06-04 |
| 1649490814 | Charles Douglas Littell | Physician Assistant | 26 Miles West of Green River, Green River, WY 82935-0872 | 2007-04-27 |
| 1386780237 | Charles F Harris | Physician Assistant | 982 W. Broadway, Jackson, WY 83002 | 2007-01-29 |
| 1194815225 | Barbara A. Shear | Physician Assistant | 2417 East 15th Street, Casper, WY 82609 | 2006-10-12 |
| 1952498230 | Daniel Janssen | Physician Assistant | 900 Cy Ave, Casper, WY 82601-4174 | 2006-10-06 |
| 1376638338 | Steven John Platz | Physician Assistant | 8195 State Hwy 789, Lander, WY 82520 | 2006-10-04 |
| 1811094154 | Kenneth L. Chastek | Physician Assistant | Employee Health Solutions, 245 South Fenway, Casper, WY 82601 | 2006-09-20 |
| Find all providers with the same taxonomy | ||||
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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.