Heather Bernice Boulting, ACNPC-AG

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

95010323 Issued in CA

Practice address

875 Blake Wilbur Dr
Palo Alto, CA 94304-2205

Phone

(650) 498-6000

NPI assigned

Jan 4, 2019

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

Medicare fee-for-service enrollment

Enrolled in CA

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: hboulting691875@hisp.ehr.sutterhealth.org

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.

• Surgical Associates Inc

  • Trauma Surgery Physician
  • Modesto, CA
  • NPI 1366824161
  Medicare reassignment
• Stanford Health Care

  • General Acute Care Hospital
  • Stanford, CA
  • NPI 1437292927
  NPD (past)

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

{
    "created_epoch": "1546560000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1592352000000",
    "number": "1043783830",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3025 ARGONAUT AVE",
            "city": "ROCKLIN",
            "state": "CA",
            "postal_code": "956771820",
            "telephone_number": "530-320-8040"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "875 BLAKE WILBUR DR",
            "city": "PALO ALTO",
            "state": "CA",
            "postal_code": "943042205",
            "telephone_number": "650-498-6000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1700 Coffee Rd",
            "address_purpose": "LOCATION",
            "city": "Modesto",
            "state": "CA",
            "postal_code": "953552803",
            "country_code": "US",
            "telephone_number": "530-320-8040",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BOULTING",
        "first_name": "HEATHER",
        "middle_name": "BERNICE",
        "credential": "ACNPC-AG",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-01-04",
        "last_updated": "2020-06-17",
        "certification_date": "2020-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "95010323",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Charbel Bou Khalil
• Ian Anthony Boucher, PA-C
• David Jean-Guy Boudreault, M.D.
• Jennifer Boule, MD
• Heidi M Boules, MD
• Matthew Richard Bourne
• Molly Bowdring, PHD
• Bowers and on Endodontic Partnership
• Dorothy Hofen Bowers Wu
• Anna Bowers, DDS

• Nurse Practitioner in Palo Alto, CA
• Providers in Palo Alto, CA by specialty
• Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2020; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.