Carolyn A. Boutwell, CRNA

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

1-092497 Issued in AL

Practice address

810 St. Vincent'S Dr.
Birmingham, AL 35205

Phone

(205) 939-7143

NPI assigned

Jun 19, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in AL

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Registered Nurse

State licenses

Practice roles

Locations

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

• Blue Lake Health Alabama, LLC

  • Anesthesiology Physician
  • Florence, AL
  • NPI 1376266726
  Medicare reassignment NPD
• University of Alabama Health Services Foundation, PC.

  • Multi-Specialty Clinic/Center
  • Birmingham, AL
  • NPI 1093768723
  Medicare reassignment NPD
• Anesthesia Services of Birmingham, P.C.

  • Anesthesiology Physician
  • Birmingham, AL
  • NPI 1184663064
  NPD (past)
• St Vincents East

  • Family Medicine Physician
  • Birmingham, AL
  • NPI 1336257211
  NPD (past)

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

{
    "created_epoch": "1150675200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1013952233",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1123",
            "city": "JACKSON",
            "state": "MI",
            "postal_code": "492041123",
            "telephone_number": "800-242-1131"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "810 ST. VINCENT'S DR.",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "35205",
            "telephone_number": "205-939-7143"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOUTWELL",
        "first_name": "CAROLYN",
        "middle_name": "A.",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-19",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "AL",
            "license": "1-092497",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "009992635",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC&BS OF ALABAMA",
            "identifier": "515-26962",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Robert C Bourge, MD
• Sydearia Shaylee Bouris
• Garrett Austin Bourne, MD
• Sarah Bouslog, MD
• Ronald E Bousman, MD
• Therese Bouvier, LPC
• Shelby Leanne Bowden, CRNP
• Alexis A Bowen, MD
• Anna Bowen, PHARMD
• Brittany Michelle Bowen, CRNP

• Certified Registered Nurse Anesthetist in Birmingham, AL
• Providers in Birmingham, AL by specialty
• Certified Registered Nurse Anesthetist in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.