Active NPI
Jacqueline Elise Bouley, DC
- Chiropractor
- Needham, MA
National Provider Identifier
1023074176
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 3049
- Practice address
- 114 1St Ave
Needham, MA 02494-2824 - Phone
- (617) 939-6752
- NPI assigned
- Apr 25, 2006
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 3049 | MA | Primary |
Addresses
Primary practice location
114 1St Ave
Needham, MA 02494-2824
Mailing address
652 Central Ave
Needham, MA 02494-1407
Phone (617) 939-6752
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3049 | MA | MD | Chiropractor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Wellspace Associates | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Physical Therapist
- Cambridge, MA
- NPI 1346291317
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1145923200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1330041600000",
"number": "1023074176",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "652 CENTRAL AVE",
"city": "NEEDHAM",
"state": "MA",
"postal_code": "024941407",
"telephone_number": "617-939-6752"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "114 1ST AVE",
"city": "NEEDHAM",
"state": "MA",
"postal_code": "024942824",
"telephone_number": "617-939-6752"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BOULEY",
"first_name": "JACQUELINE",
"middle_name": "ELISE",
"name_prefix": "Dr.",
"credential": "DC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-04-25",
"last_updated": "2012-02-24",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "MA",
"license": "3049",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Needham, MA
- Boston Foundation for Sight
- Boston Hearing Associates, Inc.
- Boston Neuropsychological Services, LLC
- Boston Premier Allergy Asthma and Immunology
- Boston University Affiliated Physicians
- Nicole Bourassa, M.S. CCC-SLP
- Pamela Daniels Bourque, MSW, LICSW
- Elizabeth M Bowen
- Blythe Elizabeth Bowman, M.D.
- Katherine Mary Bradley, N.P.
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.