Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Ryland Boehnke, DO

Individual provider Emergency Medicine Physician · NPI 1780387142

Ryland Boehnke, DO is an Emergency Medicine in Jackson, Mississippi. Qualified in 2023, 3 years ago. Practices with Grenada Emergency Group, LLC, a 37-clinician group and accepts Medicare assignment. Licensed in Mississippi.

Years since qualifying
3
Licensed in
MS
In the registry since
2023
Specialties on file
2
What do these letters mean?
DO — Doctor of Osteopathic Medicine
A fully licensed physician, trained like an MD with additional musculoskeletal training. Equivalent practice rights in all 50 states.

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Practice location Address checks out

2500 N State St
Jackson, MS 39216-4500
Phone: (601) 984-1000
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Emergency Medicine Physician (primary) Taxonomy 207P00000X · Licence 35199 (MS)
Student in an Organized Health Care Education/Training Program Taxonomy 390200000X

Record details

NPI number1780387142
Entity typeIndividual (Type 1)
GenderMale
Credentials DO
Sole proprietorNo
NPI enumeratedMarch 24, 2023
Last updated in NPPESJune 2, 2025
Certification dateJune 2, 2025
Mailing address8509 W 6th Ave, Kennewick, WA 99336-9440

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyEMERGENCY MEDICINE
Medical schoolOTHER
Graduated 2023 (3 years in practice)
Group practice Grenada Emergency Group, Llc — 37 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

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