KELLY PATRICE BOGGAN MD - NPI 1003923962 - Pediatrics in Knoxville, TN

Q: What is Kelly Boggan's NPI number?

The NPI number for Kelly Boggan is 1003923962. It was assigned to this individual provider in the NPPES registry on August 24, 2006. The provider is also known as Kelly Patrice Hicks.

Q: What is Kelly Boggan's specialty?

The primary specialty registered for this NPI is Pediatrics with taxonomy code 208000000X.

Q: When was this NPI record last updated?

The NPPES record for Kelly Boggan was last updated on March 4, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

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About Kelly Patrice Boggan Md NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

KELLY PATRICE BOGGAN MD (NPI 1003923962) is an individual pediatrics provider in Knoxville, Tennessee, licensed in Tennessee (24699) and active in the NPI registry since August 2006.

NPPES Registry Identity

NPI1003923962

Entity TypeIndividualFemale

Primary Taxonomy208000000X

Provider Legal NameKELLY PATRICE BOGGANCredential: MD

Location Address1400 DUTCH VALLEY DRKnoxville, TN 37918-1424

Mailing AddressPo Box 15004Knoxville, TN 37901-5004 · (865) 541-8895 · Fax (865) 633-4808

Phone(865) 689-1122

Fax(865) 689-2923

Sole ProprietorNo

Enumeration DateAugust 24, 2006

Last NPPES UpdateMarch 4, 2019

✔ NPI 1003923962 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPediatricsAllopathic & Osteopathic Physicians

Taxonomy Code208000000X

License✔ Licensed in TN · 24699

Definition

A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.

1400 DUTCH VALLEY DR, Knoxville, TN 37918

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Other Names 1

Former Name (1)Kelly Patrice Hicks

Other Identifiers 1

Medicaid3077452TN

Other Providers at the Same Location NPPES 12

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

ASHLEY BATEMAN

Social Worker (Clinical)