Kevin Boudinot

Primary specialty

Critical Care Registered Respiratory TherapistTaxonomy code 2279C0205X

License

044405 Issued in AZ

Practice address

Corner of Routes N12 & N7
Fort Defiance, AZ 86504

Phone

(928) 729-8000

NPI assigned

Jul 5, 2022

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1656979200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1656979200000",
    "number": "1003549304",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4141 W BRADSHAW CREEK LN",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850875811"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "CORNER OF ROUTES N12 & N7",
            "city": "FORT DEFIANCE",
            "state": "AZ",
            "postal_code": "86504",
            "telephone_number": "928-729-8000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOUDINOT",
        "first_name": "KEVIN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-07-05",
        "last_updated": "2022-07-05",
        "certification_date": "2022-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2279C0205X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Respiratory Therapist, Registered, Critical Care",
            "state": "AZ",
            "license": "044405",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "N/a",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "Corner of Routes N12 & N7",
            "city": "Fort defiance",
            "state": "AZ",
            "country_code": "US",
            "postal_code": "86504",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Melonie I Blancaneaux
• Miranda Frances Blatchford, LCSW
• Floyd Bodden, PA
• Ray Bolivar, CRT
• Rosemary Josephine Bolza, CNM
• Brittany Bowks, RN
• Ulysses S Bowler Jr., MD
• Rebecca Bowling, RN
• Hunter M Bowring
• Valentina V Brandon, RN

• Critical Care Registered Respiratory Therapist in Fort Defiance, AZ
• Providers in Fort Defiance, AZ by specialty
• Critical Care Registered Respiratory Therapist in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 5, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.