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BOARDMAN HEALTH AND WELLNESS, PLLC
NPI 1063453363
Physician Assistant in S Boardman, MI

Active since June 09, 2006
4713 PINE ST SW, S BOARDMAN, MI 49680(231) 369-2656 Get Directions Write a Review

NPPES record last updated: September 11, 2025. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Sep 11, 2025, Aug 22, 2020 (2 updates tracked since 2020).

About Boardman Health And Wellness, Pllc NPPES

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

BOARDMAN HEALTH AND WELLNESS, PLLC (NPI 1063453363) is a healthcare organization registered as a physician assistant in S Boardman, Michigan and active in the NPI registry since June 2006. The organization lists Thomas Keane Stetler, Officer, as its authorized official.

NPPES Registry Identity

NPI1063453363
Entity TypeOrganization
Primary Taxonomy363A00000X
Legal Business NameBOARDMAN HEALTH AND WELLNESS, PLLC
Location Address4713 PINE ST SWS Boardman, MI 49680-9761
Mailing Address4713 Pine St SwS Boardman, MI 49680-9761 · (231) 369-2656
Phone(231) 369-2656
Organization SubpartNo
Authorized OfficialThomas Keane StetlerOfficer · (231) 369-2656
Enumeration DateJune 9, 2006
Last NPPES UpdateSeptember 11, 20252 updates tracked since enumeration
✔ NPI 1063453363 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363A00000X
License✔ Licensed in MI · 5601003799
Definition
A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.
Also ListedFamily MedicineTaxonomy 207Q00000X · License 4301069428 (MI)
4713 PINE ST SW, S Boardman, MI 49680
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Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Other Providers at the Same Location NPPES 4

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

THOMAS KEANE STETLER PA-C
Physician Assistant
4713 PINE ST SW
S BOARDMAN, MI 49680
Kalkaska County (231) 518-0189
BOARDMAN HEALTH AND WELLNESS, PLLC
Family Medicine
4713 PINE ST SW
SOUTH BOARDMAN, MI 49680
Kalkaska County (231) 369-2656
BOARDMAN FAMILY PRACTICE PLLC
Clinic/Center (Rural Health)
4713 PINE ST SW
SOUTH BOARDMAN, MI 49680
Kalkaska County (231) 518-0189
TODD M KREYKES PA.C
Physician Assistant
4713 PINE ST SW
SOUTH BOARDMAN, MI 49680
Kalkaska County (231) 369-2656

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Boardman Health And Wellness, PLLC's NPI number?

The NPI number for Boardman Health And Wellness, PLLC is 1063453363. It was assigned to this organization in the NPPES registry on June 9, 2006.

Where is Boardman Health And Wellness, PLLC located?

Boardman Health And Wellness, PLLC is located at 4713 Pine St SW, S Boardman, MI 49680. The listed phone number is (231) 369-2656.

What is Boardman Health And Wellness, PLLC's specialty?

The primary specialty registered for this NPI is Physician Assistant with taxonomy code 363A00000X.

When was this NPI record last updated?

The NPPES record for Boardman Health And Wellness, PLLC was last updated on September 11, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 months 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.