Katelin Ashley Bouchard, APRN

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

9445 Issued in CT

Practice address

130 Collins Rd
Bristol, CT 06010-3859

Phone

(860) 919-5626

NPI assigned

Jan 22, 2021

Last updated

Feb 26, 2021By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in CT

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2020

Medicare assignment

May accept Medicare assignment

Group practices

Impact Health PCGroup PAC ID 0941562664, 79 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Griffin Hospital Hospital, Derby, CT, CCN 070031

Merit-based Incentive Payment System (MIPS)

Final score

94 of 100Reported as group

Quality

83.66

Promoting interoperability

100

Improvement activities

40

Cost

66.78

Merit-based Incentive Payment System (MIPS)

Final score

97.06 of 100Reported as group

Quality

87.5

Promoting interoperability

100

Improvement activities

40

Cost

77.51

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kbouchard@landmarkhealth-direct.org

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Impact Health P.C.

  • Nurse Practitioner
  • Orange, CT
  • NPI 1730694316

  Family

  Medicare reassignment Care Compare group NPD
• Midstate Medical Center

  • General Acute Care Hospital
  • Meriden, CT
  • NPI 1154425288
  Medicare reassignment NPD
• The Hospital of Central Connecticut at New Britain General and Bradley

  dba The Hospital of Central Connecticut

  • Hospitalist Physician
  • New Britain, CT
  • NPI 1063461481
  Medicare reassignment NPD
• Midstate Medical Center

  • Psychiatric Hospital Unit
  • Meriden, CT
  • NPI 1316022718
  NPD
• The Hospital of Central Connecticut at New Britain General and Bradley

  dba The Hospital of Central Connecticut

  • Psychiatric Hospital Unit
  • New Britain, CT
  • NPI 1992867006
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• The Griffin Hospital

  • General Acute Care Hospital
  • Derby, CT
  • NPI 1184639973
  Care Compare affiliation

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

{
    "created_epoch": "1611273600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614297600000",
    "number": "1013507110",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "130 COLLINS RD",
            "city": "BRISTOL",
            "state": "CT",
            "postal_code": "060103859",
            "telephone_number": "860-919-5626"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "130 COLLINS RD",
            "city": "BRISTOL",
            "state": "CT",
            "postal_code": "060103859",
            "telephone_number": "860-919-5626"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOUCHARD",
        "first_name": "KATELIN",
        "middle_name": "ASHLEY",
        "credential": "APRN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-01-22",
        "last_updated": "2021-02-26",
        "certification_date": "2021-02-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CT",
            "license": "9445",
            "primary": true
        },
        {
            "code": "207QH0002X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Hospice and Palliative Medicine",
            "state": "CT",
            "license": "9445",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Janessa Elise Bodzon, LCSW
• C David Bomar, M.D.
• Nelson A Bondhus, MD
• April Bontempo, MSN, APRN, FNP-BC
• Deborah Borgerding
• Eugene W Boudreau, RN
• Sarah Bourgoin, PHARM D
• Emily Macomber Bourret, PHARMD
• Arcola Renee Bowden, LCSW
• Driola Brahaj

• Family Nurse Practitioner in Bristol, CT
• Providers in Bristol, CT by specialty
• Family Nurse Practitioner in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.