Thaddeus Jason Boughton, ANP-BC

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

License

1139488 Issued in AL

Practice address

1110 E 6TH Street Suite E
Muscle Shoals, AL 35661

Phone

(256) 314-2431

Fax

(256) 314-2435

NPI assigned

Apr 4, 2013

Sex

Male

Sole proprietor

No

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

Enrolled in AL

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

Vanderbilt University School of Medicine, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Registered Nurse, Nurse Practitioner

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.

• Diabetes and Wellness Clinic of the Shoals

  • Clinic/Center
  • Muscle Shoals, AL
  • NPI 1255892865
  Medicare reassignment NPD Authorized official
• Shoals Primary Care, LLC

  • Family Medicine Physician
  • Sheffield, AL
  • NPI 1326373861
  Medicare reassignment NPD

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

{
    "created_epoch": "1365033600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1557360000000",
    "number": "1043553357",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1110 E 6TH STREET SUITE E",
            "city": "MUSCLE SHOALS",
            "state": "AL",
            "postal_code": "356613669",
            "telephone_number": "256-314-2431"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1110 E 6TH STREET SUITE E",
            "city": "MUSCLE SHOALS",
            "state": "AL",
            "postal_code": "35661",
            "telephone_number": "256-314-2431",
            "fax_number": "256-314-2435"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1110 E 6th Street Suite E",
            "address_purpose": "LOCATION",
            "city": "Muscle Shoals",
            "state": "AL",
            "postal_code": "35661",
            "country_code": "US",
            "telephone_number": "256-314-2431",
            "fax_number": "256-314-2435",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BOUGHTON",
        "first_name": "THADDEUS",
        "middle_name": "JASON",
        "name_prefix": "Mr.",
        "credential": "ANP-BC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-04-04",
        "last_updated": "2019-05-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "AL",
            "license": "1139488",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "thad@diabetesandwellnessshoals.com",
            "affiliation": "N",
            "endpointDescription": "work email",
            "address_1": "1110 E 6th Street Suite E",
            "city": "Muscle Shoals",
            "state": "AL",
            "country_code": "US",
            "postal_code": "356613669",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Tabitha Nicole Blasingame, DNP
• Sarah Blaylock, OTR/L
• BLSC Thompson Group Inc
• Dalton J Boley, LCSW
• Bernard D Borosky, M.D.
• Lauren Bourland, MS, CCC-SLP
• David William Bowen, D.M.D
• Donald J Bowling, M.D.
• Britta Patterson Bowman, LPC
• Micah David Boyer, DPT

• Adult Health Nurse Practitioner in Muscle Shoals, AL
• Providers in Muscle Shoals, AL by specialty
• Adult Health Nurse Practitioner in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 9, 2019; 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.